Toxic Epidermal Necrolysis-Like Cutaneous Lupus in Pediatric Patients: A Case Series and Review. Pediatrics 2016 Jun;137(6)
Date
06/02/2016Pubmed ID
27245834DOI
10.1542/peds.2015-4497Scopus ID
2-s2.0-84971500225 (requires institutional sign-in at Scopus site) 17 CitationsAbstract
Bullous eruptions in patients with underlying systemic lupus erythematosus (LE) can mimic toxic-epidermal necrolysis (TEN), a rapidly progressive mucocutaneous reaction usually associated with medication use. Differentiating between classic drug-induced TEN and TEN-like cutaneous LE is important but difficult. We report a series of 3 patients with pediatric systemic LE who were admitted with severe worsening of skin disease resembling TEN. However, the initial photo-distribution of the eruption, subacute progression, limited mucosal involvement, mild systemic symptoms, supportive biopsy and laboratory results, and lack of culprit drugs was more suggestive of a TEN-like cutaneous LE. These patients recovered with various systemic immunosuppressive medications including methylprednisolone, intravenous immunoglobulin, and plasmapheresis. Our cases are rare and demonstrate key clinical and histologic features of TEN-like cutaneous LE in young patients and the importance of differentiating this entity from drug-induced TEN.
Author List
Yu J, Brandling-Bennett H, Co DO, Nocton JJ, Stevens AM, Chiu YEAuthors
Yvonne E. Chiu MD Vice Chair, Professor in the Dermatology department at Medical College of WisconsinJames J. Nocton MD Professor in the Pediatrics department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AdolescentBiopsy
Child
Diagnosis, Differential
Female
Humans
Lupus Erythematosus, Cutaneous
Lupus Erythematosus, Systemic
Male
Skin
Stevens-Johnson Syndrome
