Malar rash: SLE riesacerbation during pregnancy.
This 32 year old woman had a 5 year history of SLE: the disease had presented with malar rash, discoid LE lesions on the scalp, arthralgia and an acute episode of pleural effusion.
Laboratory investigations disclosed high titers of antinuclear antibodies with an homogeneous pattern on HEp-2 cells, anti-nDNA, anti-SS-A and IgG-anticardiolipin antibodies.
Treatment with hydroxychloroquine (200 mg/d) and prednisone (average of 25 mg/d) adequately controlled the systemic disease.
Unfortunately during pregnancy she had a disease flare-up with impressive cutaneous manifestations which did not respond to treatment but slowly regressed after childbirth.