This 30 year old woman has had SLE since the age of 20 with several episodes of arthritis, leukopenia, anemia, malar rash, oral ulcers, vasculitic purpura on the lower extremities and lupus-pancreatitis.
The patient was treated with high dose steroids, azathioprine, cyclosporin A and plasma-apheresis.
The malar rash has only partially responded to the systemic treatment with residual involvement of the nose and a resulting "lupus pernio-like" clinical aspect.