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Systemic lupus erythematosus presenting as Stevens-Johnson syndrome and toxic epidermal necrolysis: a report of three cases.
Lupus. 2011 May; 20(6):647-52.L

Abstract

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are life-threatening dermatological conditions that are characterized by mucositis, epidermal detachment and erosions. The underlying etiology in SJS and TEN is almost invariably secondary to drugs. Rarely, other causes such as systemic lupus erythematosus (SLE), infections and vaccinations have been implicated. This report describes three patients with SLE who presented with manifestations of SJS/TEN without a clear drug causality. All three patients presented with photodistributed macular exanthema, which evolved to target lesions, bullae, erosions or sheet-like detachment. This was associated with oral mucositis and conjunctivitis. The onset of the rash was insidious with a protracted clinical course. Ultraviolet exposure and steroid tapering appear to be precipitating factors. In two of the patients, SJS and TEN were the initial presentation of lupus. Although SJS and TEN are almost invariably due to medications, they may, rarely, be an initial presentation of lupus, particularly when associated with an initial photodistribution, absence of genital involvement and a prolonged clinical course.

Authors+Show Affiliations

Dermatology Unit, Singapore General Hospital, Singapore. hauryueh@starhub.net.sgNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

21148602

Citation

Lee, H Y., et al. "Systemic Lupus Erythematosus Presenting as Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: a Report of Three Cases." Lupus, vol. 20, no. 6, 2011, pp. 647-52.
Lee HY, Tey HL, Pang SM, et al. Systemic lupus erythematosus presenting as Stevens-Johnson syndrome and toxic epidermal necrolysis: a report of three cases. Lupus. 2011;20(6):647-52.
Lee, H. Y., Tey, H. L., Pang, S. M., & Thirumoorthy, T. (2011). Systemic lupus erythematosus presenting as Stevens-Johnson syndrome and toxic epidermal necrolysis: a report of three cases. Lupus, 20(6), 647-52. https://doi.org/10.1177/0961203310385162
Lee HY, et al. Systemic Lupus Erythematosus Presenting as Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: a Report of Three Cases. Lupus. 2011;20(6):647-52. PubMed PMID: 21148602.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Systemic lupus erythematosus presenting as Stevens-Johnson syndrome and toxic epidermal necrolysis: a report of three cases. AU - Lee,H Y, AU - Tey,H L, AU - Pang,S M, AU - Thirumoorthy,T, Y1 - 2010/12/10/ PY - 2010/12/15/entrez PY - 2010/12/15/pubmed PY - 2011/9/15/medline SP - 647 EP - 52 JF - Lupus JO - Lupus VL - 20 IS - 6 N2 - Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are life-threatening dermatological conditions that are characterized by mucositis, epidermal detachment and erosions. The underlying etiology in SJS and TEN is almost invariably secondary to drugs. Rarely, other causes such as systemic lupus erythematosus (SLE), infections and vaccinations have been implicated. This report describes three patients with SLE who presented with manifestations of SJS/TEN without a clear drug causality. All three patients presented with photodistributed macular exanthema, which evolved to target lesions, bullae, erosions or sheet-like detachment. This was associated with oral mucositis and conjunctivitis. The onset of the rash was insidious with a protracted clinical course. Ultraviolet exposure and steroid tapering appear to be precipitating factors. In two of the patients, SJS and TEN were the initial presentation of lupus. Although SJS and TEN are almost invariably due to medications, they may, rarely, be an initial presentation of lupus, particularly when associated with an initial photodistribution, absence of genital involvement and a prolonged clinical course. SN - 1477-0962 UR - https://www.unboundmedicine.com/medline/citation/21148602/Systemic_lupus_erythematosus_presenting_as_Stevens_Johnson_syndrome_and_toxic_epidermal_necrolysis:_a_report_of_three_cases_ L2 - https://journals.sagepub.com/doi/10.1177/0961203310385162?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -