1/16. Rowell's syndrome.Rowell's syndrome is the name given to a distinct group of patients with lupus erythematosus who develop erythema multiforme-like lesions and have a characteristic serological picture. We report a case of a 29-year-old woman of Afro-Caribbean origin who presented with an erythema multiforme-like eruption on the hands. Subsequently she developed painful erythematous swellings on the feet and scaly plaques on the forearm and thigh consistent with subacute cutaneous lupus. She developed a positive antinuclear factor and had positive anti-Ro and anti-La antibodies and a positive rheumatoid factor. All of these features are consistent with Rowell's syndrome which we believe is a rare but distinct variant of cutaneous lupus erythematosus.- - - - - - - - - - ranking = 1keywords = lupus erythematosus, erythematosus, lupus (Clic here for more details about this article) |
2/16. Lupus erythematosus associated with erythema multiforme: does Rowell's syndrome exist?We describe a patient with lupus erythematosus who experienced an unusual erythema multiforme-like eruption suggestive of Rowell's syndrome. We compare our case and 9 other reports of lupus erythematosus associated with erythema multiforme to the 4 cases reported by Rowell. Our findings indicate that Rowell's original criteria are not well preserved. The coexistence of lupus erythematosus with erythema multiforme does not impart any unusual characteristics to either disease, and the immunologic disturbances in such patients are probably coincidental.- - - - - - - - - - ranking = 2.0750656880321keywords = lupus erythematosus, erythematosus, lupus (Clic here for more details about this article) |
3/16. Lupus erythematosus with antiphospholipid syndrome and erythema multiforme-like lesions.The occurrence of erythema multiforme (EM) in patients with lupus erythematosus (LE) has been described previously as a coincidental association. In contrast, LE with EM-like lesions and a peculiar immunological pattern, including positive rheumatoid factor, antinuclear antibodies and a serum antibody against an extract of human tissues recently recognized as similar to Ro (SSA), constitutes an established entity named Rowell's syndrome. We describe a woman with LE and long-standing widespread vesiculobullous and necrotic haemorrhagic EM-like lesions in combination with Ro (SSA) and scl-70 antibodies and the typical laboratory findings of the antiphospholipid syndrome (APS), namely lupus anticoagulant, anticardiolipin antibodies and prolonged activated partial thromboplastin time. This case could conceivably be consistent with a diagnosis of Rowell's syndrome, if the latter is regarded as a clinicopathological spectrum. However, the coexistence of LE, persistent EM-like disease and incomplete APS may also fulfil the diagnostic criteria for the 'multiple autoimmune syndromes'. We speculate that the laboratory markers of APS play a pivotal part in such an unusual clinical presentation.- - - - - - - - - - ranking = 1.1110583619708keywords = lupus erythematosus, erythematosus, lupus (Clic here for more details about this article) |
4/16. Redefining Rowell's syndrome.Rowell's syndrome is believed to be a distinct and rare clinical entity originally described as lupus erythematosus associated with erythema multiforme-like lesions with immunological findings of speckled antinuclear antibodies, anti-La antibodies and a positive test for rheumatoid factor. We report two additional patients with Rowell's syndrome and review all the diagnostic criteria found in the literature. In view of the inconsistent findings of some of the diagnostic features, we propose that major and minor criteria be used to diagnose Rowell's syndrome.- - - - - - - - - - ranking = 0.49100183151534keywords = lupus erythematosus, erythematosus, lupus (Clic here for more details about this article) |
5/16. A case of unusual SLE related syndrome characterized by erythema multiforme, angioneurotic edema, marked hypocomplementemia, and Clq precipitins of the low molecular weight type.Our patient and those of Agnello et al. had identical clinical symptoms such as erythema multiforme, arthralgias and angioneurotic edema and both differed from systemic lupus erthematosus in several important points, i.e., in spite of marked hypocomplementemia the nephropathy is not prominent and it needs high-dose steroids to eliminate the clinical and serological abnormalities. In addition to the features reported by Agnello et al. we found increased viral antibody titers in our patient's sera.- - - - - - - - - - ranking = 0.02013673715588keywords = lupus, systemic lupus (Clic here for more details about this article) |
6/16. Lupus erythematosus with an erythema multiforme-like eruption.We describe a patient diagnosed with lupus erythematosus (LE) who developed an acute generalized eruption characterized by erythema multiforme (EM)-like lesions. biopsy specimen showed foci of vacuolar alteration at the dermo-epidermal junction and frequent necrotic keratinocytes. Laboratory tests disclosed a speckled-homogenous antinuclear antibody titer of 1:640, leucopenia and hypocomplementemia. Anti-Ro/anti-La antibodies and rheumatoid factor were negative. Treatment with high-dose oral prednisone and azathioprine led to complete remission of the cutaneous lesions, although eruption recurred two years later. We believe that this patient presented a subacute cutaneous lupus eythematous with a distinctive erythema multiforme-like eruption. This case could be included in the so-called Rowell's syndrome, although it does not fit all the immunological characteristics reported in the original description, as in many of the previously reported cases. At the present time there seems to be enough evidence to classify Rowell's syndrome within the subacute cutaneous lupus erythematosus subset. Finally, a coexistence of LE and EM can not be completely discarded in our patient, although no causative factor was found.- - - - - - - - - - ranking = 1.6020601934861keywords = lupus erythematosus, erythematosus, lupus (Clic here for more details about this article) |
7/16. Kikuchi disease with facial rash and erythema multiforme.Kikuchi disease, or histiocytic necrotizing lymphadenitis, is a benign illness characterized by fever and cervical lymphadenopathy predominantly in young women. It has a self-limiting course. skin changes occur in about one-third of patients and are of a nonspecific nature. A case of Kikuchi disease with cutaneous involvement in the guise of erythema multiforme and a facial rash is reported. The differential diagnosis with systemic lupus erythematosus and Rowell syndrome is discussed.- - - - - - - - - - ranking = 0.50133083464025keywords = lupus erythematosus, erythematosus, lupus, systemic lupus erythematosus, systemic lupus (Clic here for more details about this article) |
8/16. Neonatal erythema multiforme major.A 25-day-old neonate developed an unusual eruption with bullae and marked systemic symptoms. Investigation for bacterial, viral, autoimmune and immunobullous causes did not reveal any identifiable trigger and histological examination was highly suggestive of bullous erythema multiforme. Pulmonary infiltrates were noted late in the course of the disease. Differential diagnoses included bullous impetigo, primary herpes simplex infection, immunobullous disease, neonatal lupus and erythema multiforme. This case illustrates the difficulties in diagnosing and managing an unwell child with bullae and emphasizes the need to exclude treatable underlying causes.- - - - - - - - - - ranking = 0.017996336969316keywords = lupus (Clic here for more details about this article) |
9/16. Rowell's syndrome and associated antiphospholipid syndrome.We report a 27-year-old primigravida with systemic lupus erythematosus, erythema multiforme-like lesions and a peculiar immunological pattern consisting of antinuclear antibody (speckled pattern) and rheumatoid factor, an association known as Rowell's syndrome. She also had a probable antiphospholipid syndrome as evidenced by the presence of a prolonged activated partial thromboplastin time, kaolin clotting time and thrombocytopenia.- - - - - - - - - - ranking = 0.50133083464025keywords = lupus erythematosus, erythematosus, lupus, systemic lupus erythematosus, systemic lupus (Clic here for more details about this article) |
10/16. Bullous subacute cutaneous lupus erythematosus.We describe a 59-year-old woman, with a history of autoimmune disease and disseminated uterine leiomyosarcoma, who developed a photoaggravated, blistering skin eruption. An initial rash, at the outset of treatment with chemo- and radiotherapy, resembled erythema multiforme. review of the original skin biopsy showed it to be subacute cutaneous lupus erythematosus. There were no systemic symptoms or signs to suggest systemic lupus erythematosus. The much later photoaggravated rash consisted mainly of bullae and eventual epidermal denuding which resembled toxic epidermal necrolysis. We propose that the clinical and histological diagnosis is one of bullous subacute cutaneous lupus erythematosus in a patient with no other features of systemic lupus erythematosus.- - - - - - - - - - ranking = 3.9486726583725keywords = lupus erythematosus, erythematosus, lupus, systemic lupus erythematosus, systemic lupus (Clic here for more details about this article) |
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