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Document Details : Title: A red face in a lupus patient: thinking beyond lupus rash Author(s): STUBBE M, SMITH V, THEVISSEN K, MIELANTS H, DE KEYSER F Journal: Acta Clinica Belgica Volume: 65 Issue: 1 Date: 2010 Pages: 44-47 DOI: 10.2143/ACB.65.1.1002384 Abstract : A 61-year old woman with a history of systemic lupus erythematosus presented with a facial rash followed by fever. The diagnosis of lupus fl are was made by the general practioner who prescribed corticosteroids. The evolution was unfavorable and the patient was hospitalized. On admission, she presented with high fever and a sharply demarcated papular erythema overlying her cheeks. Biology was infl ammatory with elevated C-reactive protein, sedimentation rate and leucocyte count. The diagnosis of erysipelas of the face was made on the basis of the malar and non pruritic papular erythema, fever, the high C-reactive protein levels and the absence of response to corticosteroids. The evolution was favorable under intravenous antibiotics and rapid tapering of the corticosteroids. To our knowledge, this is the fi rst report of facial erysipelas in a patient with a history of systemic lupus erythematosus. This coincidence is a rare condition which may lead to erroneous diagnosis and inappropriate therapy. |
