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The last word on the so-called 'Rowell's syndrome'?
E Antiga1, M Caproni, D Bonciani
1Department of Medical and Surgical Critical Care, Section of Clinical, Allergo-immunological and Infettivological Dermatology, University of Florence, Florence, Italy. emiliano.antiga@unifi.it
Lupus
|December 16, 2011
Summary
Rowell's syndrome (RS) is questionable, as few reported cases meet all original criteria. The study suggests that co-occurrence of cutaneous lupus erythematosus and erythema multiforme doesn't warrant a distinct syndrome.
Area of Science:
- Dermatology
- Immunology
- Pathology
Background:
- Rowell's syndrome (RS) has been reported in 71 patients, but most cases lack the defining clinical and serological features.
- Subacute cutaneous lupus erythematosus (SCLE) and erythema multiforme (EM) have since been better defined, leading to questions about RS's validity.
Purpose of the Study:
- To critically evaluate the concept of Rowell's syndrome.
- To review and compare the features of SCLE and EM with reported RS cases.
- To determine if the coexistence of cutaneous lupus erythematosus (CLE) and EM constitutes a separate syndrome.
Main Methods:
- Comprehensive literature review of all reported Rowell's syndrome cases.
- Analysis of clinical, histopathological, and immunopathological features of SCLE and EM.
- Comparison of diagnostic criteria and observed features in RS patients versus established SCLE and EM criteria.
Main Results:
- Only a minority of reported RS cases exhibit a true association between discoid lupus erythematosus (DLE) and EM.
- The coexistence of CLE and EM, similar to CLE with lichen planus or psoriasis, is likely coincidental.
- Most reported RS cases do not fulfill the original diagnostic criteria established in 1963.
Conclusions:
- The existence of Rowell's syndrome as a distinct entity is not supported by current evidence.
- The association between CLE and EM is not sufficient to define a separate syndrome.
- Clinical and diagnostic re-evaluation suggests RS may represent overlapping or coincidental conditions rather than a unique syndrome.
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