Rowell Syndrome is a rare presentation of lupuserythematosus manifesting as an eruption oferythema multiforme-like papules and plaques withimmunological findings of positive rheumatoidfactor, speckled antinuclear antibodies, and/or antiRo/La antibodies. This case highlights the unusualand highly debated presentation of RowellSyndrome in a 66-year-old woman with newlyappearing erythematous, targetoid plaques in thesetting of previously diagnosed systemic lupuserythematosus. Skin biopsy revealed histologicalfeatures of full-thickness epidermal necrosis withfocal sub-epidermal separation and a superficialperivascular lymphocytic infiltrate interpreted tofavor Rowell Syndrome given her clinical history andpresentation. Although no standard treatment exists,a prednisone taper and topical corticosteroidsproved effective initially, with complete resolution atsix months on mycophenolate mofetil andbelimumab.
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