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    Toxic epidermal necrolysis-like lupus

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    Author
    Roberts, Elizabeth
    Melchionda, Veronica
    Saldanha, Gerald
    Shaffu, Shireen
    Royle, Jeremy
    Harman, Karen
    Keyword
    Lupus erythematosus, systemic
    Skin
    Stevens-Johnson syndrome
    Toxic epidermal necrosis
    
    Metadata
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    DOI
    doi.org/10.1111/ced.14648
    Publisher's URL
    https://onlinelibrary.wiley.com/doi/10.1111/ced.14648
    Abstract
    Toxic epidermal necrosis (TEN)-like lupus is a rare condition characterized by epidermal loss and mucosal ulceration occurring in patients with acute severe flares of systemic lupus erythematosus. The clinical picture may mimic drug-induced Stevens-Johnson syndrome/TEN; however, the absence of a suitable culprit drug, and the context of acute lupus point to the correct diagnosis. In a case series of three patients, further discriminating features included a slower onset of epidermal loss, more limited mucosal ulceration and a lack of ocular involvement when compared with drug-induced TEN. Histology may show similar features, including basal layer vacuolation, apoptosis and full-thickness epidermal necrosis. Patients with TEN-like lupus may have additional features of lupus, and a lupus band on direct immunofluorescence. It is important to identify this condition correctly, so that these patients can be appropriately managed with early input from Rheumatologists and prompt treatment with high-dose combined immunosuppressant therapy.
    Citation
    Roberts, E. J., Melchionda, V., Saldanha, G., Shaffu, S., Royle, J., & Harman, K. E. (2021). Toxic epidermal necrolysis-like lupus. Clinical and experimental dermatology, 46(7), 1299–1303.
    Type
    Article
    URI
    http://hdl.handle.net/20.500.12904/15206
    Collections
    Pathology
    Rheumatology
    Dermatology

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