Pustular and crusted lesions in systemic lupus erythematosus: A case report

Area of Science:

• Dermatology
• Rheumatology
• Infectious Disease

Background:

• Systemic lupus erythematosus (SLE) is a complex autoimmune disease with diverse clinical manifestations, often affecting the skin.
• While various cutaneous lesions are recognized in SLE, pustular and crusted eruptions are less common.
• Differential diagnoses for pustular lesions in SLE include other dermatoses and infections.

Observation:

• A patient with known SLE developed severe pustular and crusted skin lesions.
• Initial differential diagnoses considered were pustular dermatoses and vasculitis.
• Microscopic examination of skin scrapings revealed the presence of scabies mites.

Findings:

• The patient was diagnosed with SLE complicated by crusted scabies.
• The unusual presentation mimicked primary pustular skin conditions.
• Identification of scabies mites was crucial for accurate diagnosis.

Implications:

• This case underscores the importance of considering opportunistic infections, like scabies, in patients with SLE presenting with atypical skin findings.
• Prompt diagnosis and combined treatment with immunosuppressants and scabicides led to clinical improvement.
• Highlights the need for a broad differential diagnosis in complex autoimmune cases.