[A new case of Rowell's syndrome]

Area of Science:

• Dermatology
• Rheumatology
• Pathology

Background:

• Rowell's syndrome, the association of lupus erythematosus and erythema multiforme, remains a controversial diagnostic entity.
• Established diagnostic criteria exist, yet its distinctness from other lupus erythematosus presentations is debated.

Observation:

• A 43-year-old woman developed drug-induced lupus erythematosus (esomeprazole), followed by characteristic erythema multiforme lesions, including target-like and erosive eruptions on skin and oral mucosa.
• Histopathology confirmed sub-epidermal blistering and keratinocytic necrosis, consistent with erythema multiforme, after other causes were excluded.
• Treatment with hydroxychloroquine and corticosteroids led to complete remission of both lupus erythematosus and erythema multiforme.

Findings:

• The patient presented with annular lesions, mucosal involvement, and specific histological findings distinct from typical subacute lupus erythematosus.
• The successful treatment and remission of both conditions suggest a unique pathological process potentially defining Rowell's syndrome.
• The distinct clinical and histological features observed in this case contribute to the ongoing debate regarding Rowell's syndrome as a singular entity.

Implications:

• This case highlights the importance of recognizing distinct clinical and histological features that may support Rowell's syndrome as a separate entity.
• Further research and case studies are needed to solidify the diagnostic criteria and understanding of Rowell's syndrome.
• Accurate diagnosis and management of Rowell's syndrome are crucial for effective patient outcomes in autoimmune blistering diseases.