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Case report
Toxic epidermal necrolysis-like subacute cutaneous lupus erythematosus associated with lung carcinoma
  1. Luís Santiago1,
  2. Rosa Mascarenhas2,
  3. Óscar Tellechea1 and
  4. Margarida Gonçalo1
  1. 1 Department of Dermatology, Hospital and University Centre of Coimbra, Coimbra, Portugal
  2. 2 Department of Dermatology, Hospital Distrital da Figueira da Foz, Figueira da Foz, Portugal
  1. Correspondence to Dr Luís Santiago; luisgsantiago2{at}


Specific vesiculobullous skin lesions in lupus erythematosus (LE) are rare and must be differentiated from toxic epidermal necrolysis (TEN), TEN-like dermatoses and other vesiculobullous conditions. We report a patient with typical subacute cutaneous lupus erythematous that progressed with large sheet-like areas of epidermal detachment and Nikolsky sign resembling TEN. She had a serological profile suggestive of underlying connective tissue disease, histological findings of interface dermatitis with a lymphocytic infiltrate, positive direct immunofluorescence, resolution with immunomodulation and lack of a culprit drug, features observed in TEN-like cutaneous lupus erythematous. Furthermore, she was diagnosed with lung carcinoma, an association that has been previously reported. Differentiating a bullous eruption in the context of pre-existing LE remains difficult requiring a thorough analysis of clinical and histopathological data.

  • dermatology
  • rheumatology
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  • Contributors LS: wrote the paper and data collection. RM and ÓT: critical revision of the article. MG: final approval of the version to be published.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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