[A case of systemic lupus erythematosus with urticarial vasculitis]

A 37-year-old woman with SLE who presented with urticarial vasculitis is reported. Skin biopsy revealed presence of polymorphonuclear and mononuclear leukocyte infiltration, nuclear dust, extravasation of red blood cells and fibrinoid necrosis of small vessels which are characteristic features of leukocytoclastic vasculitis. In the literature, 49 cases with similar skin lesion have been reported under various terminologies including unusual SLE related syndrome, hypocomplementemia with cutaneous vasculitis and arthritis, urticarial vasculitis or hypocomplementemic vasculitic urticarial syndrome. Approximately 50% of these cases fulfilled the revised criteria for SLE. It is suggested that these cases represent a unique group of patients with characteristic skin manifestations and polyarthritis mediated by immune complex, and closely relate to SLE.