Toxic Epidermal Necrolysis-Like Lupus Erythematosus, a condition to exclude in all patients with possible Stevens-Johnson syndrome/Toxic Epidermal Necrolysis.

Abstract

In patients with acute epidermal necrolysis, the most frequent diagnosis is Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) and less frequently Toxic Epidermal Necrolysis-like Lupus Erythematosus (TEN-LE). Both groups of conditions present with erythema, papules and/or bullae, and sheet-like detachment of skin.1 Proposed features to support TEN-LE include the absence of high-risk drug use, UV-exposure, an insidious onset of symptoms, a photo-distributed cutaneous eruption, minimal mucosal involvement, and autoimmune serology consistent with systemic lupus erythematosus (SLE).