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Bullous systemic lupus erythematosus.

M G Fleming¹, W F Bergfeld, K J Tomecki

¹Department of Dermatology, Cleveland Clinic Foundation, Ohio 44106.

International Journal of Dermatology

|June 1, 1989

Summary

Bullous systemic lupus erythematosus (SLE) can be drug-induced, a rare presentation not previously documented. Hydralazine may trigger this severe cutaneous manifestation in susceptible individuals.

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Area of Science:

Rheumatology
Dermatology
Clinical Pharmacology

Background:

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with diverse clinical manifestations.
Bullous dermatoses are uncommon in SLE, and their association with drug-induced lupus erythematosus (DILE) is rare.
Hydralazine is a known cause of drug-induced lupus.

Observation:

Two patients presented with clinical and histopathological features of bullous SLE.
In one patient, the onset of bullous SLE coincided with hydralazine therapy.
Cutaneous lesions in this case included widespread blistering.

Findings:

This report describes the first documented cases of bullous SLE potentially induced by hydralazine.
The cutaneous manifestations observed were distinct and characteristic of a severe blistering disease.

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Histopathological examination confirmed lupus erythematosus but with prominent bullous changes.

Implications:

Drug-induced lupus should be considered in the differential diagnosis of bullous dermatoses, especially in patients on medications like hydralazine.
This finding expands the spectrum of known cutaneous manifestations of DILE.
Further research is warranted to understand the mechanisms underlying drug-induced bullous SLE.