A Case of Bullous Systemic Lupus Erythematosus

Kong, Soo Deuk; Koo, Bon Sik; Kim, Byung Chun; Lee, Kyu Suk

Abstract

Vesiculobullous eruptions are a rare cutaneous manifestation of systemic lupus erythematosus (SLE). They are related to intense inflammation within the cutaneous lesions and subsequent blister formation. We report a case of vesiculobullous eruption of SLE in a 23-year-old male. The bullous eruptions were present ori the lip, forehead, both feet and hands. He met ARA(American Rheumatism Association) is criteria for a diagnosis of SLE and the eruptions developed during a systemic attack of the disease. Routine histology of the lesion showed subepidermal blisters with intact epidermis and dense neutrophilic infiltration in the upper dermis. Direct immunofluorescence of lesional skin showed a linear-granular pattern of immune deposits at the dermoepidermal junction. Electronmicroscopy of the lesional skin showing subepidermal bullae are located beneath the lamina densa. Combination therapy of prednisolone and hydrochloroquine showed complete clearing of the lesions within several weeks. We observed a good response without evidence of recurrence.