Acute Cutaneous Lupus Erythematosus

Butterfly malar rash.

Clinical Background:

This 26 year old male patient came to our attention in February 1994 with a recent onset of SLE: a few months earlier he had started to suffer from photosensitive cutaneous eruptions with malar rash, arthralgia, stiffness and constitutional symptoms (weakness and low-grade fever).   He received only short cycles of NSAID treatment until November when laboratory examinations revealed significant proteinuria, lymphopenia, complement consumption and increased immunoglobulin levels.
A few days before admission to our Department, a peculiar erythematous eruption appeared on the face with an irregular shape extending from the malar area to the cheeks.  High titers of antinuclear autoantibodies, anti-nRNP and anti-SS-A autoantibodies were found and a renal biopsy revealed a membrano-proliferative lupus glomerulonephritis.  He was therefore treated with high dose prednisone and plasma-exchange with good results.