European Journal of Rheumatology
Case Reports

A Diagnostic Conundrum: Unusual Presentation of Acute Cutaneous Lupus Erythematosus Mimicking Toxic Epidermal Necrolysis

1.

Department of General Medicine, All India Institute of Medical Sciences, Nagpur, India

Eur J Rheumatol 2025; 12: 1-4
DOI: 10.5152/eurjrheum.2025.24030
Read: 254 Downloads: 231 Published: 24 March 2025

Systemic lupus erythematosus (SLE) is an intricate autoimmune disorder with diverse clinical presentations, encompassing various cutaneous manifestations. This case report describes a diagnostically challenging occurrence of acute cutaneous lupus erythematosus (ACLE) exhibiting a toxic epidermal necrolysis (TEN)-like rash in a 28-year-old female already diagnosed with SLE. The patient’s rapid progression from itching to maculopapular skin eruptions involving the face, extremities, and torso within days, coupled with facial puffiness and systemic symptoms, presented a clinical conundrum. Histopathological findings of epidermal hyperkeratosis, acanthosis, and a subcorneal neutrophilic abscess guided the exclusion of other conditions, emphasizing the distinctive features of TEN-like ACLE. The patient exhibited a favorable response to pulse methylprednisolone, mycophenolate mofetil, and hydroxychloroquine.

Cite this article as: Kamble N, Khot R, Barai S, Chaudhari S, Rathod B, Awadhiya O. A diagnostic conundrum: unusual presentation of acute cutaneous lupus erythematosus mimicking toxic epidermal necrolysis. Eur J Rheumatol. 2025;12(1):1-4.

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