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Bullous SLE: response to methotrexate and relationship with disease activity
G Malcangi1, G Brandozzi, M Giangiacomi
1Istituto di Clinica Medica Generale, Ematologia ed Inmunologia Clinica, Torrette di Ancona, Italy.
Lupus
|February 18, 2003
Summary
Methotrexate effectively treated a severe bullous eruption in a patient with systemic lupus erythematosus (SLE). This case highlights methotrexate
Area of Science:
- Rheumatology
- Dermatology
- Immunology
Background:
- Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with diverse clinical manifestations.
- Bullous eruptions are rare but severe cutaneous manifestations of SLE.
- Previous treatments were not tolerated by the patient.
Observation:
- A 40-year-old female with SLE presented with a severe bullous eruption on sun-exposed skin.
- The bullous eruption coincided with a flare in lupus serologies.
- The patient had a history of intolerance to multiple medications.
Findings:
- Oral methotrexate (10 mg/week) was administered due to prior drug intolerance.
- Methotrexate led to rapid and complete resolution of the bullous skin lesions.
- Five months post-treatment, the patient developed class III lupus nephritis.
Implications:
- This is the first reported case of methotrexate efficacy in treating bullous SLE.
- The findings suggest a potential link between bullous eruptions and SLE disease activity.
- Further research is warranted to explore methotrexate's role in managing bullous SLE.