A Rare And Severe Complication Of SLE: Bullous Systemic Lupus Erythematous
DOI:
https://doi.org/10.33102/mjosht.v8i.289Keywords:
BSLE, Septic Shock, Therapeutics, OutcomeAbstract
Bullous systemic lupus erythematosus (BSLE) is a rare antibody-mediated blistering eruption of subepidermal tissues in patients with underlying SLE. We report a case of a 19 years old Indian unconscious male who presented with acute generalized blistering lesion and widespread tense vesicles and Bullae at the superior trunk, proximal superior limbs, and face(lips) with the symmetrical distribution. Bullae contained haemorrhagic fluid and bleeding was also seen on the ruptured site. The lesions are also seen on mucosal areas such as perioral, pharyngeal, laryngeal, and genital areas. Multiple erosions and crusting lesions are also seen over the body. Multiple scalp plaque erythematous peeling lesions with foul smells. Blood investigation showed leucocytosis and metabolic acidosis with a diagnosis of septic shock secondary to infected BSLE. He was treated with IV hydrocortisone 200mg, analgesic, and IV Ceftriaxone. Unfortunately, he collapsed 24 hours later and passed away. This case report highlights the importance of early detection of BSLE as an acute skin complication in patients with underlying SLE and its management steps.
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Odonwodo, Amaka, and Priyanka Vashisht. "Bullous Systemic Lupus Erythematosus." In StatPearls [Internet]. StatPearls Publishing, 2022. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557445/
Fors Nieves, C. E., & Izmirly, P. M. (2016). Mortality in systemic lupus erythematosus: an updated review. Current rheumatology reports, 18(4), 1-7. doi.org/10.1007/s11926-016-0571-2
Contestable, J. J., Edhegard, K. D., & Meyerle, J. H. (2014). Bullous systemic lupus erythematosus: a review and update to diagnosis and treatment. American journal of clinical dermatology, 15(6), 517-524. doi.org/10.1007/s40257-014-0098-0
Chan, L.S., Lapiere, J.C., Chen, M., Traczyk, T., Mancini, A.J., Paller, A.S., Woodley, D.T. and Marinkovich, M.P. (1999). Bullous systemic lupus erythematosus with autoantibodies recognizing multiple skin basement membrane components, bullous pemphigoid antigen 1, laminin-5, laminin-6, and type VII collagen. Archives of Dermatology, 135(5), 569-573. doi.org/ 10.1001/archderm.135.5.569
Danza, A., & Ruiz-Irastorza, G. (2013). Infection risk in systemic lupus erythematosus patients: susceptibility factors and preventive strategies. Lupus, 22(12), 1286-1294. doi.org/10.1177/0961203313493032
Gupta, R., Woodley, D. T., & Chen, M. (2012). Epidermolysis bullosa acquisita. Clinics in dermatology, 30(1), 60-69. doi.org/10.1016/j.clindermatol.2011.03.011
Ko, C. J., Colegio, O. R., Moss, J. E., & McNiff, J. M. (2010). Fibrillar IgA deposition in dermatitis herpetiformis–an underreported pattern with potential clinical significance. Journal of cutaneous pathology, 37(4), 475-477. doi.org/10.1111/j.1600-0560.2009.01472.x
Lipsker D. Bullous systemic lupus erythematosus. In: Callen J, Ofori A, editors. UpToDate [Internet]. Waltham (MA): UpToDate Inc; 2020 [cited 2022 May 27]. Available from: https://www.uptodate.com/contents/bullous-systemic-lupus
Duan, L., Chen, L., Zhong, S., Wang, Y., Huang, Y., He, Y., Chen, J. and Shi, G. (2015). Treatment of bullous systemic lupus erythematosus. Journal of immunology research, 2015. doi.org/10.1155/2015/16706
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Copyright (c) 2022 Rosdara Masayuni Mohd Sani, Chuan Yi Foo, Muhammad Mujibuddin Hassan, Michael Yang Song Lim, Chen Liang Tan, Ling Chian Voon
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