Malar rash during SLE riesacerbation.
This 26 year old woman had a history of SLE onset at the age of 22 with malar rash, oral ulcers, arthralgia and arthritis.
High titers of antinuclear antibodies, anti-nDNA, anti-Sm, anti-SS-A and IgG anticardiolipin autoantibodies were found therefore she was treated with hydroxychloroquine (200mg/d) and prednisone (20mg/d) with adequate control of the systemic disease.
A month ago she noticed the reappearance of ACLE with malar dermatitis and a rash involving the upper trunk and the extensor surface of the arms, oral ulcers, fever and arthralgia.
She was then admitted to our Department where initial laboratory investigations revealed anemia, lymphopenia and thrombocytopenia.
During this period she had two episodes of epileptic seizures due to cerebral vasculitis and was therefore treated with high dose 6-methyl-prednisolone (1g/d for 3 days and then 50mg/d), phenitoin and phenobarbital.