Erythema Multiforme Like Lesions in a Case of Systemic Lupus Erythematosus

Cutaneous involvement may be seen in 70-85% of patients with systemic lupus erythematosus. Erythema multiforme like lesions are considered as non-specific findings in lupus erythematosus and are rarely seen in the systemic form. Seventeen-year-old woman admitted to our clinic with multiple, violet colored, targetoid lesions on the palms and dorsal areas of both hands and dorsal areas of the feet with a 4-month of duration. She was complaining of photosensitivity and hair loss for a few years. Histopathologic examination revealed hyperkeratosis, parakeratosis, single cell necrosis through the epidermis and perivascular mixed cellular infiltration. C3 and C1q were detected at the dermoepidermal junction in immunofluorescence examination. In laboratory, antinuclear antibody was positive. Elevated sedimentation rate, anemia, and hypocomplementemia were detected. Lupus band test was positive. According to these findings, the patient was diagnosed as systemic lupus erythematosus and the lesions on the hand and feet as erythema multiforme like lesions. Methylprednisolone (1mg/kg/day) was started. Notable improvement in her symptoms and in the clinical appearance of the lesion was observed. Erythema multiforme like lesions are the cutaneous findings rarely seen in systemic lupus erythematosus. In the present case, since there was no drug use or herpes virus infection in the history.