Bullous subacute cutaneous lupus erythematosus.
We describe a 59-year-old woman, with a history of autoimmune disease and disseminated uterine leiomyosarcoma, who developed a photoaggravated, blistering skin eruption. An initial rash, at the outset of treatment with chemo- and radiotherapy, resembled erythema multiforme. Review of the original skin biopsy showed it to be subacute cutaneous lupus erythematosus. There were no systemic symptoms or signs to suggest systemic lupus erythematosus. The much later photoaggravated rash consisted mainly of bullae and eventual epidermal denuding which resembled toxic epidermal necrolysis. We propose that the clinical and histological diagnosis is one of bullous subacute cutaneous lupus erythematosus in a patient with no other features of systemic lupus erythematosus.
Perera
G K
GK
St John's Institute of Dermatology, London, UK. gayathriperera@aol.com
Black
M M
MM
McGibbon
D H
DH
D000970:Antineoplastic Agents / Q000009:adverse effects; D001768:Blister / Q000209:etiology*; D003937:Diagnosis, Differential; D003875:Drug Eruptions / Q000175:diagnosis; D004892:Erythema Multiforme / Q000175:diagnosis; D005260:Female; D006801:Humans; D008178:Lupus Erythematosus, Cutaneous / Q000175:diagnosis*; D008875:Middle Aged; D010787:Photosensitivity Disorders / Q000175:diagnosis*; D013262:Stevens-Johnson Syndrome / Q000175:diagnosis; D013472:Sunlight / Q000009:adverse effects
D000970:Antineoplastic Agents