A Case of Systemic Lupus Erythematosus with Cutaneous Leukocytoclastic Vasculitis Mimicking Bullous SLE.
A Case of Systemic Lupus Erythematosus with Cutaneous Leukocytoclastic Vasculitis Mimicking Bullous SLE.
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系统性红斑狼疮合并皮肤白细胞破碎性血管炎疑似大疱性系统性红斑狼疮1例。
DOI：
10.1159/000519022
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发表时间：
2021-09
影响因子：
0.9
通讯作者：
Asada H
中科院分区：
文献类型：
--
作者：
Miyagawa F;Ogawa K;Hashimoto T;Asada H
系统性红斑狼疮(SLE)患者很少会出现大疱性皮疹，狭义上称为大疱性SLE的疾病具有抗III型胶原的自身抗体。我们描述了一个罕见的病例，SLE患者在她的双腿上出现了广泛的大疱性大疱病。组织学上，大疱性病变提示为白细胞碎裂性血管炎，血管壁内有C3沉积。免疫印迹分析和酶联免疫吸附试验抗III型胶原抗体均为阴性。我们最初认为是大疱性系统性红斑狼疮，但最终诊断为继发性血管炎。口服强的松龙剂量增加，水泡性皮损消失。系统性红斑狼疮患者皮肤血管炎的临床表现包括可触及的紫癜性皮疹、瘀点、丘疹结节病变和网状肝纤维化。大疱性皮损似乎并不常见。医生需要意识到，即使患者没有表现出很高的疾病活动度，SLE继发性脉管炎也可能导致广泛的水泡。
Rarely, patients with systemic lupus erythematosus (SLE) develop bullous eruptions, a disease called bullous SLE in a narrow sense that has autoantibodies against type VII collagen. We describe an unusual case in which a patient with SLE developed extensive bullae on her lower extremities. Histologically, the bullous lesions were suggestive of leukocytoclastic vasculitis with deposition of C3 within blood vessel walls. Immunoblot analyses and enzyme-linked immunosorbent assays were negative for anti-type VII collagen antibodies. We initially considered bullous SLE, but eventually made a diagnosis of secondary vasculitis in SLE. The oral prednisolone dose was increased, and the vesiculobullous lesions resolved. The clinical presentations of cutaneous vasculitis in SLE include palpable purpura, petechiae, papulonodular lesions, and livedo reticularis. Bullous lesions seem to be uncommon. Physicians need to be aware that extensive bullae can occur as a result of secondary vasculitis in SLE, even if the patient does not exhibit high disease activity.
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