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Updated: Aug 24, 2025

Skin Biopsy for Diagnosing Discoid Lupus Erythematosus
Published on: June 10, 2025
An Indonesian female with Stevens-Johnson syndrome mimicking cutaneous lupus: A case report
Nadya Meilinar Samson1, Awalia1
1Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga - Dr Soetomo General Academic Hospital, Surabaya, Indonesia.
Background:
Diagnosing bullous eruptions in systemic lupus erythematosus (SLE) patients is challenging because there are so many differential diagnoses, including drug reactions such as Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN) and TEN-like cutaneous lupus erythematosus (LE).
Case Presentation:
An Indonesian female with a SLE history complained of an erythematous rash over the body 2 weeks ago. A pulse dose of methylprednisolone was given, and after 3 days, of getting bullae appeared all over the body and treatment stopped. The patient is treated in collaboration with dermatology, ophthalmology, and allergy consultants to obtain a diagnosis of SJS supporting skin biopsy. The patient was given methylprednisolone 62.5 mg once daily for 7 days, Gentamicin 80 mg twice daily, and the skin lesion was treated with NaCl 0.9% compression. The patient showed improvement and decreased methylprednisolone dose to 16 mg 3 times a day.
Discussion:
Skin biopsy must be obtained to establish the diagnosis between JSJ/TEN and cutaneous LE.
Conclusion:
SJS/TEN can occur in SLE patients. The correct diagnosis can reduce the patient's mortality and morbidity.
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