Estherly Grace M Gonzales, Kristy Pinoy-Villamayor and Richard John Pelo
Bicol Medical Center, Philippines
Scientific Tracks Abstracts: J Infec Dis Treat
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.
Estherly Grace M. Gonzales has completed her pre medical degree of Bachelor of Science in Nursing at the age 20 from Universidade de Sta. Isabel as cum laude and had her medical degree at the age of 26 years from Far Eastern University- Dr. Nicanor Reyes Medical Foundation. She is currently on resident training in the Department of Internal Medicine in Bicol Medical Center, a premier hospital of Bicol Region in the Philippines.