Bullous systemic lupus erythematosus: An uncommon manifestation in pediatric population

María Trinidad Hasbún Z, María Paz Rollan, Ximena Chaparro R, Cecilia Fischer S, Adriana Castrillón V, Sergio González B, Francisca Reculé
Andes pediatrica: revista Chilena de pediatría 2021, 92 (3): 428-433

INTRODUCTION: Bullous systemic lupus erythematosus (BSLE) is an autoimmune subepidermal blistering disease se condary to the presence of autoantibodies against type VII collagen of the basement membrane zone. It is considered a variant of Systemic Lupus Erythematosus (SLE) and is uncommon in the pediatric population.

OBJECTIVE: To describe the case of a pediatric patient with a bullous eruption compati ble with BSLE.

CLINICAL CASE: A 16-year-old female patient of Mapuche descent with history of SLE diagnosed at age 10, undergoing treatment. She consulted due to a six-week history of a generalized bullous eruption with no systemic symptoms. Biopsy for histology and direct immunofluorescence (DIF) confirmed the diagnosis of BSLE. The patient responded favorably to dapsone 100 mg/day (associated with her baseline treatment), without new reactivations after 8 years of follow-up. Con clusion: BSLE is an infrequent manifestation of SLE. The clinical presentation is similar to other bullous dermatoses, but the histopathology and DIF in correlation with the presence of SLE confirm the diagnosis. Although indigenous ancestry is associated with SLE high-risk alleles, studies regarding the association of BSLE in this ethnic group are still lacking.

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