Rowell syndrome in pregnancy: A diagnostic challenge

Rowell syndrome is comprised of erythema multiforme-like lesions in association with lupus erythematosus along serologies speckled antinuclear antibodies, positive rheumatoid factor, anti-La/ anti-Ro and the clinical finding chilblains.1 currently classified as a subtype chronic cutaneous erythematosus.2 The majority cases are seen women aged 20-70 years. ratio affected to men 8:1. Indian patients have median age 23 compared 32 worldwide less likely be discoid lupus.3 We report case pregnancy. A 29 year old primigravida at period gestation 15 weeks developed vasculitic lesions, palms, soles, oral ulceration suggestive LE lesions. She also had Alopecia universalis, Taenia corporaris scabies masking which was diagnostic challenge. Laboratory investigations revealed ANA+1:640 speckled, Anti Ro+++, La +++. histology targetoid consistent multiforme. patient successfully managed on low-dose aspirin hydroxychloroquine. Lesions showed significant improvement one month. Early diagnosis, multidisciplinary team approach, intensive monitoring during antenatal were key successful outcome who normal vaginal delivery female child term. This reflects that we should suspect even young without precipitating features further must reported help increase knowledge pathophysiology syndrome.