Lupus erythematosus-specific bullous lesions: A case report
Abstract
Rationale: Lupus erythematosus-specific bullous lesions (LE-SBL) is a rare cutaneous phenotype of lupus erythematosus, characterized by tense vesicles or bullae that readily mimic other primary bullous disorders.
Patient concerns: A 79-year-old man presented with an abrupt onset of extensive tense bullae and erosions on the trunk, extremities, and oral mucosa, accompanied by pruritus and pain; no systemic involvement was detected.
Diagnoses: Histopathology revealed a subepidermal blister with a predominantly lymphocytic infiltrate. Enzyme-linked immunosorbent assay for anti-type VII collagen antibodies was negative. Serologic studies demonstrated a markedly elevated anti-Ro-52 antibody titer (>500 U/mL) and a weakly positive antinuclear antibody (1:80, nucleolar pattern). A diagnosis of LE-SBL was established.
Interventions: Intravenous methylprednisolone combined with oral hydroxychloroquine was administered, supplemented by symptomatic care.
Outcomes: After systematic treatment, the patient's blisters subsided and the eroded areas healed, with no new skin lesions observed during the follow-up period.
Lessons: This study provides a comprehensive analysis of LE-SBL and further refines current understanding of the disease. Integration of histopathology, direct/indirect immunofluorescence, and serologic testing is essential to distinguish this entity from other bullous dermatoses. Early institution of glucocorticoids plus hydroxychloroquine achieves rapid disease control. This…
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