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A red face in a lupus patient: thinking beyond lupus rash.
Acta Clin Belg 2010 Jan-Feb; 65(1):44-7AC

Abstract

A 61-year-old woman with a history of systemic lupus erythematosus presented with a facial rash followed by fever. The diagnosis of lupus flare was made by the general practioner who prescribed corticosteroids. The evolution was unfavorable and the patient was hospitalized. On admission, she presented with high fever and a sharply demarcated papular erythema overlying her cheeks. Biology was inflammatory with elevated C-reactive protein, sedimentation rate and leucocyte count. The diagnosis of erysipelas of the face was made on the basis of the malar and non pruritic papular erythema, fever, the high C-reactive protein levels and the absence of response to corticosteroids. The evolution was favorable under intravenous antibiotics and rapid tapering of the corticosteroids. To our knowledge, this is the first report of facial erysipelas in a patient with a history of systemic lupus erythematosus. This coincidence is a rare condition which may lead to erroneous diagnosis and inappropriate therapy.

Authors+Show Affiliations

Reumatologie, Universitair Ziekenhuis Gent, Gent, België.

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

20373598

Citation

Stubbe, M, et al. "A Red Face in a Lupus Patient: Thinking Beyond Lupus Rash." Acta Clinica Belgica, vol. 65, no. 1, 2010, pp. 44-7.
Stubbe M, Smith V, Thevissen K, et al. A red face in a lupus patient: thinking beyond lupus rash. Acta Clin Belg. 2010;65(1):44-7.
Stubbe, M., Smith, V., Thevissen, K., Mielants, H., & De Keyser, F. (2010). A red face in a lupus patient: thinking beyond lupus rash. Acta Clinica Belgica, 65(1), pp. 44-7.
Stubbe M, et al. A Red Face in a Lupus Patient: Thinking Beyond Lupus Rash. Acta Clin Belg. 2010;65(1):44-7. PubMed PMID: 20373598.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A red face in a lupus patient: thinking beyond lupus rash. AU - Stubbe,M, AU - Smith,V, AU - Thevissen,K, AU - Mielants,H, AU - De Keyser,F, PY - 2010/4/9/entrez PY - 2010/4/9/pubmed PY - 2010/6/11/medline SP - 44 EP - 7 JF - Acta clinica Belgica JO - Acta Clin Belg VL - 65 IS - 1 N2 - A 61-year-old woman with a history of systemic lupus erythematosus presented with a facial rash followed by fever. The diagnosis of lupus flare was made by the general practioner who prescribed corticosteroids. The evolution was unfavorable and the patient was hospitalized. On admission, she presented with high fever and a sharply demarcated papular erythema overlying her cheeks. Biology was inflammatory with elevated C-reactive protein, sedimentation rate and leucocyte count. The diagnosis of erysipelas of the face was made on the basis of the malar and non pruritic papular erythema, fever, the high C-reactive protein levels and the absence of response to corticosteroids. The evolution was favorable under intravenous antibiotics and rapid tapering of the corticosteroids. To our knowledge, this is the first report of facial erysipelas in a patient with a history of systemic lupus erythematosus. This coincidence is a rare condition which may lead to erroneous diagnosis and inappropriate therapy. SN - 1784-3286 UR - https://www.unboundmedicine.com/medline/citation/20373598/A_red_face_in_a_lupus_patient:_thinking_beyond_lupus_rash_ L2 - http://www.tandfonline.com/doi/full/10.1179/acb.2010.007 DB - PRIME DP - Unbound Medicine ER -