Estherly Grace M Gonzales
Bicol Medical Center, Philippines
Title: I’ve got you under my skin: A case of toxic epidermal necrolysis-like cutaneous manifestation of systemic lupus erythematosus
Biography
Biography: Estherly Grace M Gonzales
Abstract
Introduction: Systemic Lupus Erythematosus has several presentation and cutaneous lesion is the second most frequent presentation of SLE. Toxic Epidermal Necrolysis-like cutaneous lupus erythematosus was considered as a rare variant of Acute Cutaneous Lupus Erythematosus with different presentation with the classical drug-induced TEN. Differentiating the two entity will be useful in the management and determining the outcome of the patient.
Objectives: : In this report, we present a rare presentation of a newly diagnosed case of Systemic Lupus Erythematosus presenting with Toxic Epidermal Necrolysis-Like skin lesions. Specifically, to present the clinical manifestations, approach to management and correlate it with previous case reports.
Case: A 37 years old female who presented with 6 years history of multiple joint pains, alopecia, photosensitivity, and intermittent undocumented fever. She was admitted due to appearance of TEN-like skin lesions. This case was diagnosed with SLE based on SLICC Criteria: hematologic, mucocutaneous and autoimmune criteria. TEN- like cutaneous lupus erythematosus was considered by using Naranjo and Hartwig scoring system. Patient was managed with steroids and hydroxychloroquine wherein lesions resolved.
Conclusion: This case highlighted that TEN is not always due to drug reaction hence, may be attributed to other disease. This concluded that TEN like cutaneous lupus erythematousus does exist and it is a rare manifestation of SLE. Early recognition, proper physical examination, and diagnostic procedure should be done in a prompt manner to aid in the diagnosis and treatment.