Keratoderma in Systemic Lupus Erythematosus: An Unusual Cutaneous Manifestation of Disease?

Systemic lupus erythematosus (SLE) is a multi-organ autoimmune disease, with the skin being the second most affected organ after the joints. We present a unique case of a 44-year-old female who presented with an acute flare of SLE and the concurrent onset of keratoderma on both lower limbs. She pres...

Full description

Saved in:
Bibliographic Details
Published inCurēus (Palo Alto, CA) Vol. 14; no. 10
Main Authors CA, Jayashankar, Bhanu, Prakash, Dandu, Sravanthi S, Joshi, Amey, Salam, Hiba, Barre, Lenora S, Nallamothu, Sree N
Format Journal Article
LanguageEnglish
Published Palo Alto Cureus Inc 26.10.2022
Cureus
Subjects
Abdomen
Acids
Allergy/Immunology
Alopecia
Antibodies
Baldness
Biopsy
Blood
Case reports
Debridement
Dermatology
Hemoglobin
Histopathology
Internal Medicine
Legs
Lupus
Mutation
Patients
Proteins
Research centers
Steroids
Systemic diseases
Urine
Online AccessGet full text

Cover

More Information
Summary:Systemic lupus erythematosus (SLE) is a multi-organ autoimmune disease, with the skin being the second most affected organ after the joints. We present a unique case of a 44-year-old female who presented with an acute flare of SLE and the concurrent onset of keratoderma on both lower limbs. She presented with high-grade fever, arthralgia, and generalized edema of four months duration. A general physical examination revealed pallor and scaly hyperpigmented plaques on both lower limbs, which was confirmed to be keratoderma on histopathological examination. Blood investigations revealed pancytopenia, elevated erythrocyte sedimentation rate (ESR) and C- reactive protein (CRP), and positive titers for anti-nuclear antibody (ANA) and anti-Po ribosomal P proteins (RPP) antibodies. Immunosuppressive medications and topical keratolytics were used to treat her successfully. Post medical management, she showed significant improvement in her symptoms. On follow-up, the patient had a complete resolution of the symptoms and remained well. This case demonstrates keratoderma as a rare incidental finding in a patient with SLE flare. Understanding SLE's various cutaneous manifestations are critical for holistically diagnosing and treating the disease.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.30736