DOI: https://dx.doi.org/10.18203/issn.2455-4529.IntJResDermatol20222732
Published: 2022-10-27

Systemic lupus erythematosus presenting with bullous lesions, cutaneous vasculitis and laryngeal ulcerations-a rare association

Mrudula Pulletikurti, K. V. T. Gopal, P. V. Krishnam Raju, B. Rekha Rani

Abstract


Bullous SLE is an uncommon complication of SLE with autoantibodies to type VII collagen of dermo-epidermal junction. We report a 31-year-old female who presented with vesiculobullous lesions in the photo exposed areas along with vasculitic lesions over palms and soles and ulcerations in the larynx. She also had history of photosensitivity and hair loss. Investigations showed significant anaemia and high titres of antibodies (ANA, anti-ds-DNA, anti Sm) confirming SLE. Histopathology showing sub epidermal blister with neutrophils and immunofluorescence favoured diagnosis of bullous SLE. The patient responded well to high dose parenteral steroids and dapsone. In view of high probability of renal involvement, patient was referred to nephrologist and is under regular follow up.

 

 


Keywords


Bullous SLE, Cutaneous vasculitis, Laryngeal ulcerations

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References


Gammon WR, Briggaman RA. Bullous eruption of systemic lupus erythematosus. In: Wojnarowska F, Briggaman RA, editors. Management of Blistering Diseases. London: Chapman and Hall Ltd. 1990; 263-75.

Vassileva S. Bullous systemic lupus erythematosus. Clin Dermatol. 2004;22:129-38.

Dainichi T, Kurono S, Ohyama B. Anti-laminin gamma-1 pemphigoid. Proc Natl Acad Sci USA. 2009;106:2800-5.

Chan LS, Lapiere JC, Chen M. Bullous systemic lupus erythematosus with autoantibodies recognizing multiple skin basement membrane components, bullous emphigoid antigen 1, laminin-5, laminin-6, and type VII collagen. Arch Dermatol. 1999;135:569-73.

Grover C, Khurana A, Sharma S, Singal A. Bullous systemic lupus erythematosus. Indian J Dermatol. 2013;58:492.

Camisa C, Sharma HM. Vesiculobullous systemic lupus erythematosus. J Am Academy Dermatol. 1983;9(6):924-33.

Gammon WR, Briggaman RA. Bullous SLE: A phenotypically distinctive but immunologically heterogenous bullous disorder. J Invest Dermatol. 1995;104:231-5.

Barile-Fabris L. Vasculitis in systemic lupus erythematosus. Curr Rheumatol Rep. 2014;16(9):440.

Teitel AD. Laryngeal involvement in systemic lupus erythematosus. Seminars Arthritis Rheumatism. 1992;22(3):203-14.

Schmidt E, Groves R. Chapter 50: Immunobullous disorders. Christopher E, Jonathan Barker. Rook’s textbook of Dermatology, 9th ed. UK: Wiley Blackwell. 2010;46-9.