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Case Report
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| Systemic lupus erythematosus presenting as erythroderma | ||||||
| Kingsuk Mukherji1, Nigel Jowett2, Julie Barber3 | ||||||
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1Specialty Doctor, Cardiology, Withybush Hospital, Hywel Dda Health Board, Fishguard Road, Haverfordwest, United Kingdom SA61 2PZ.
2Consultant Cardiologist, Withybush Hospital, Hywel Dda Health Board, Fishguard Road, Haverfordwest, United Kingdom SA61 2PZ. 3Consultant Rheumatologist, Withybush Hospital, Hywel Dda Health Board, Fishguard Road, Haverfordwest, United Kingdom SA61 2PZ. | ||||||
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| How to cite this article |
| Mukherji K, Jowett N, Barber J. Systemic lupus erythematosus presenting as erythroderma. Int J Case Rep Images 2014;5(11):772–776. |
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Abstract
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Introduction:
Systemic lupus erythematosus (SLE) is an autoimmune disorder involving multiple organs, predominantly seen in women of child-bearing age. Erythroderma is described in patients with subacute cutaneous lupus erythematosus (SCLE) but is rare in SLE. Among the cardiac manifestations, pericarditis is common but myocarditis is rare. We report a case of severe SLE presenting with erythroderma, pancytopenia, arthralgia and myocarditis.
Case Report: A 67-year-old male with a background history of hypertension, transient ischemic attack and polymyalgia rheumatica presented with severe erythroderma, malaise, arthralgia, weight loss and was found to be pancytopenic. His antinuclear antibody (ANA) was positive and double stranded DNA (dsDNA) was more than 200 IU/mL with very low complement levels. He developed lupus associated myocarditis with moderately impaired global left ventricular systolic function. He was initially started on steroids and hydroxychloroquine. But as he developed steroid induced myopathy, it was gradually tapered off and mycophenolate mofetil was started. He responded well to the treatment. He satisfied 8 of the 17 systemic lupus international collaborating clinics (SLICC) criteria establishing a diagnosis of systemic lupus erythematosus (SLE). His systemic lupus erythematosus disease activity index (SLEDAI) score came down from 17 to 2 over a period of six months of follow-up. Conclusion: Systemic lupus erythematosus may present with erythroderma. Careful clinical examination is important in all potentially multi-system diseases. | |
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Keywords:
Erythroderma, Systemic lupus erythematosus, Myocarditis, Pancytopenia, Arthralgia
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Author Contributions
Kingsuk Mukherji – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published Nigel Jowett – Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published Julie Barber – Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published |
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Guarantor of submission
The corresponding author is the guarantor of submission. |
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Source of support
None |
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Conflict of interest
Authors declare no conflict of interest. |
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Copyright
© 2014 Kingsuk Mukherji et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information. |
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