Targetoid lesions in a patient with systemic lupus erythematosus

Rowell Syndrome is a rare presentation of lupus erythematosus manifesting as an eruption erythema multiforme-like papules and plaques with immunological findings positive rheumatoid factor, speckled antinuclear antibodies, and/or anti-Ro/La antibodies. This case highlights the unusual highly debated in 66-year-old woman newly-appearing erythematous, targetoid setting previously diagnosed systemic erythematosus. Skin biopsy revealed histological features full-thickness epidermal necrosis focal sub-epidermal separation superficial perivascular lymphocytic infiltrate interpreted to favor given her clinical history presentation. Although no standard treatment exists, prednisone taper topical corticosteroids proved effective initially, complete resolution at six months on mycophenolate mofetil belimumab.