Back issues No.3 - 1999 / Case Report  

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Bullous Systemic Lupus Erythematosus

Dermatol Sinica 17: 254-262, 1999

A 22-year-old female had developed vesiculobullous eruption for more than two months. The lesions were noted over the face, neck, axillae, four extremities and trunk. Histopathological examination of the vesicular lesions showed subepidermal blister formation which contained mononuclear cells, eosinophils, polymorphonuclear neutrophils, and nuclear dusts. In the periphery of the blister, neutrophils was predominantly noted in the dermis. Direct immunofluorescence (DIF) study showed linear deposition of IgG, IgM, IgA and C3 along the basement membrane zone. DIF of NaCl-split patient's skin showed all immunoreactants of IgG, IgM, IgA and C3 at the dermal side. Indirect immunofluorescence (IIF) on normal human skin with or without 1.0 M NaCl-split method showed negative results. Skin manifestations, renal biopsy (compatible with lupus nephritis class IV), antinuclear antibody (ANA), alveolar hemorrhage of the lung, proteinuria and lymphocytopenia fulfilled the diagnostic criteria of SLE. We hereby report a case of bullous systemic lupus erythematosus and review the literature.

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