Document Type : Case Report

Authors

1 Department of Rheumatology, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

2 Department of Internal Medicine, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

3 Department of Rheumatology, Loghman Hakim Hospital, Shahid Beheshti, University of Medical Sciences, Tehran, Iran

4 Department of Clinical Pharmacy, Faculty of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran

5 Department of Dermatology, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

6 Department of Pathology, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Abstract

Rowell syndrome (RS) is a disorder characterized by the occurrence of erythema multiforme-like lesions (EM) coexisting with lupus erythematosus. It may be considered a rare subtype of lupus-specific skin lesions. Here we report a clinical presentation of RS in a 34-year-old woman with diagnosed systemic lupus erythematosus (SLE), and without any cutaneous lesion previously that presented with skin lesions and fever. Clinical, laboratory, and histopathology assessments confirmed the diagnosis of RS in the context of SLE flare-up. She was treated with methylprednisolone 1g IV daily for 3 days, then continued with oral Prednisolone, Hydroxychloroquine, and Mycophenolate mofetil. Over treatment Skin’s lesions and oral ulcers subsided gradually and disappear all skin lesions after a month, without a scar.

Keywords

Main Subjects

  1. Zeitouni N, Funaro D, Cloutier R, Gagné E, Claveau J. Redefining Rowell’s syndrome. British Journal of Dermatology 2000; 142(2):343-6. doi: 10.1046/j. 1365-2133.2000.03306.x.
  2. Torchia D, Romanelli P, Kerdel FA. Erythema multiforme and Stevens-Johnson syndrome/toxic epidermal necrolysis associated with lupus erythematosus. Journal of the American Academy of Dermatology 2012; 67(3):417-21. doi: 10.1016/j.jaad. 2011.10.012.
  3. Gladman DD, Ibanez D, Urowitz MB. Systemic lupus erythematosus disease activity index 2000. The Journal of rheumatology 2002; 29(2):288-91.
  4. Kim SS, Magro C, Granstein RD, Bass A, Erkan D. Systemic lupus erythematosus associated with Rowell's syndrome: A clinical pathology conference held by the division of rheumatology at hospital for special surgery. HSS Journal 2013; 9:289-92. doi: 10.1007/s11420-013-9356-6
  5. Alkul S, Behrens E, Stetson C. Rowell syndrome with recurrence from photoexacerbation: a case report. SAGE Open Medical Case Reports 2019; 7:2050313X19847337. doi: 10.1177/2050313X 19847 337.
  6. Bellis S, Kuhn I, Adams S, Mullarkey L, Holland A. The consequences of hyperphagia in people with Prader-Willi Syndrome: A systematic review of studies of morbidity and mortality. European Journal of Medical Genetics. 2022; 65(1):104379. doi: 10. 1016/j.ejmg.2021.104379
  7. Chandra A, Saha SK, Ray AK, Karmakar P. Rowell’s syndrome: a rare but distinct entity in rheumatology. BMJ Case Reports CP 2020; 13(9):e235173. doi: 10. 1136/bcr-2020-235173
  8. Singh S, Sheffield S, Chowdhury N, Nuthulaganti S, Vaghaiwalla Z, Ramsubeik K. Utilization of Rituximab for Refractory Rowell Syndrome. Case Reps Rheumatolo 2021; 2021:2727382. doi: 10.1155/ 2021/ 2727382
  9. Gallo L, Megna M, Festa B, Stellato P, Di Pinto R, Fabbrocini G, et al. Rowell syndrome: a diagnostic challenge. J Clin Aesthet Dermatol 2020; 13(4): 40-42.
  10. Sethy M, Padhan P, Abirami C, Maikap D. Rowell's syndrome: a case report and literature overview. Indian Dermatol Online J 2021; 12(4):608-610. doi: 10.4103/idoj.IDOJ_554_20
  11.