As a dermatologist/internist with a career-long subspecialty interest in the cutaneous manifestations of the rheumatic diseases, I found the case of refractory acute cutaneous lupus by Samantha C. Shapiro, MD, in the June 2022 issue of The Rheumatologist intriguing in several ways, and I felt my perspectives on this case might provide additional educational value…
A 25-year-old Mexican American woman with a five-year history of systemic lupus erythematosus (SLE) presents with refractory, acute cutaneous lupus erythematosus (ACLE) and subacute cutaneous lupus erythematosus (SCLE) affecting the scalp, face and hands. Her serologic phenotype is characterized by elevated anti-nuclear, anti-double-stranded deoxyribonucleic acid (dsDNA), anti-ribonucleoprotein (RNP), anti-Smith and anti-SS-A (Ro) antibodies and chronically…