Zargham Hanieh, Ghazal Stephanie, Watters Kevin, Nguyen Khue Huu
Division of Dermatology, Montreal General Hospital, McGill University Health Centre, Montreal, QC, Canada.
Faculty of Medicine, McGill University, Montreal, QC, Canada.
SAGE Open Med Case Rep. 2020 Jul 15;8:2050313X20940420. doi: 10.1177/2050313X20940420. eCollection 2020.
We present a rare case of a 61-year-old woman presenting with a widespread erosive eruption on her torso and extremities. Although the lesions were histologically compatible with toxic epidermal necrolysis, clinically the patient was hemodynamically stable, had no mucosal involvement and had no relevant medical history or potentially incriminating medications. Further investigations uncovered a new diagnosis of systemic lupus erythematosus, with this toxic epidermal necrolysis-like eruption being the first presentation of the disease. This case highlights the importance of broadening the differential diagnosis in patients presenting with acute widespread cleavage of the epidermis, using the spectrum of acute syndrome of apoptotic pan-epidermolysis as a reference.
我们报告一例罕见病例，一名61岁女性，其躯干和四肢出现广泛的糜烂性皮疹。尽管病变在组织学上与中毒性表皮坏死松解症相符，但临床上患者血流动力学稳定，无黏膜受累，且无相关病史或可能致病的药物。进一步检查发现了系统性红斑狼疮的新诊断，这种中毒性表皮坏死松解症样皮疹是该疾病的首次表现。该病例强调了以凋亡性全表皮松解急性综合征为参考，拓宽对急性广泛表皮剥脱患者鉴别诊断范围的重要性。
