Epidermolysis bullosa acquisita-like bullous lupus erythematosus

A 53-year-old African American female with longstanding history of systemic lupus erythematosus (SLE) presented with painful blisters on her dorsal hands. She had followed closely with rheumatology for her pre-existing SLE. At the time of presentation to dermatology her only systemic therapy was hydroxychloroquine 200 mg twice a day. Previously, mycophenolate mofetil had controlled her SLE; the patient had stopped this medication due to nausea. Examination of the bilateral dorsal hands revealed multiple tense vesicles on a noninflamed background admixed with hypopigmented, scarred macules.
Source: Journal of the American Academy of Dermatology - Category: Dermatology Source Type: research