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Case report
Rowell’s syndrome: a rare but distinct entity in rheumatology
  1. Atanu Chandra,
  2. Swarup Kanta Saha,
  3. Aritra Kumar Ray and
  4. Parthasarathi Karmakar
  1. Internal Medicine, R G Kar Medical College and Hospital, Kolkata, West Bengal, India
  1. Correspondence to Dr Atanu Chandra; chandraatanu123{at}gmail.com

Abstract

Rowell’s syndrome is a rare disorder characterised by an association of lupus erythematosus with erythema multiforme (EM)-like skin lesions. EM as the initial clinical presentation of systemic lupus erythematosus is also atypical and even rarer. We report the case of an 18-year-old girl admitted to our hospital with fever and polyarthralgia along with multiple discrete ill-defined target lesions with crust formation over forehead, cheek, external ears, scalp, upper chest and back (predominantly over sun-exposed areas) with ulceration over hard palate. Investigations revealed pancytopaenia, a positive rheumatoid factor, positive antinuclear antibody with a speckled pattern, anti-Smith antibody and strongly positive anti-Ro. Patient was diagnosed with Rowell’s syndrome as per clinical and laboratory features. Majority of skin lesions including oral ulcerations subsided gradually after treatment with steroids and hydroxychloroquine.

  • rheumatology
  • systemic lupus erythematosus
  • dermatology

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Footnotes

  • Contributors SKS: Substantial contributions to conception and design, acquisition of data, analysis of data, interpretation of data, drafting the article, revising it critically for important intellectual content and final approval of the version to be published. AC: Acquisition of data, analysis of data, interpretation of data, drafting the article, revising it critically for important intellectual content and final approval of the version to be published. AKR: Substantial contributions to conception and design, drafting the article, revising it critically for important intellectual content and final approval of the version to be published. PK: Revising it critically for important intellectual content and 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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