Superficial Skin Ulcers as an Initial Manifestation of Systemic Lupus Erythematosus

Cutaneous vasculitis is frequently present in patients with systemic lupus erythematosus (SLE), rheumatoid arthritis, and Sjögren's syndrome and is less common in dermatomyositis, systemic sclerosis, and relapsing polychondritis. Given the low prevalence of vasculitic involvement in this disease, the skin lesions described so far have had minimal semiological characterization. This has limited the provision of clear guidelines regarding their treatment, with most therapeutic interventions being extrapolated from idiopathic chronic leukocytoclastic vasculitis. We present the case of a female patient in her fifth decade of life who presented with superficial skin ulcers on the forearms as an initial manifestation, due to vasculitic involvement of small vessels secondary to SLE.