Open AccessToxic epidermal necrolysis-like subacute cutaneous lupus erythematosus associated with lung carcinoma
Author(s) -
Luís Santiago,
Rosa Mascarenhas,
Óscar Tellechea,
Margarida Gonçalo
Publication year - 2019
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr-2019-231152
Subject(s) - medicine , toxic epidermal necrolysis , subacute cutaneous lupus erythematosus , pathology , context (archaeology) , dermatology , paraneoplastic pemphigus , lupus erythematosus , discoid lupus erythematosus , connective tissue disease , systemic lupus erythematosus , autoimmune disease , disease , autoantibody , immunology , paleontology , biology , antibody
Specific vesiculobullous skin lesions in lupus erythematosus (LE) are rare and must be differentiated from toxic epidermal necrolysis (TEN), TEN-like dermatoses and other vesiculobullous conditions. We report a patient with typical subacute cutaneous lupus erythematous that progressed with large sheet-like areas of epidermal detachment and Nikolsky sign resembling TEN. She had a serological profile suggestive of underlying connective tissue disease, histological findings of interface dermatitis with a lymphocytic infiltrate, positive direct immunofluorescence, resolution with immunomodulation and lack of a culprit drug, features observed in TEN-like cutaneous lupus erythematous. Furthermore, she was diagnosed with lung carcinoma, an association that has been previously reported. Differentiating a bullous eruption in the context of pre-existing LE remains difficult requiring a thorough analysis of clinical and histopathological data.