Clinical characteristics of bullous systemic lupus erythematosus

Abstract

Objective To investigate the clinical features of bullous systemic lupus erythematosus(BSLE), so as to improve the physicians' understanding of this condition. Methods The clinical date of 8 BSLE patients who were hospitalized in Peking Union Medical College Hospital from January 2014 to December 2016 were analyzed.Numerical data and categorical data were analyzed using t-test and chi-square test, respectively. Results These 8 subjects accounted for 0.3% of the 2 965 hospitalized systemic lupus erythematosus (SLE) patients, including 2 males and 6 females with the mean age of (25±10) years old and median duration of 17(3~43) months. Skin lesions, as the initial symptom at onset were shown in 3 cases. Blisters or bullae occurred on the face in 6 patients (6/8), trunk in 5 patients (5/8), extremities in 5 patients(5/8). All of them arose on normal-appearing skin. BSLE often occurred in active SLE with the average SLE disease activity index (SLEDAI) score of (12±8). Renal damage (8/8) was the most common complication followed by hematological abnormality (6/8), serositis (4/8), arthritis (3/8), neurological involvement (2/8). Compare with SLE patients without BSLE, the incidence of hematuria (6 cases, 75%) and hemolytic anemia (4 cases, 50%) were statistically higher in BSLE patients. Treated by corticosteroid and immunosuppressants, 6 patients achieved clinical improvements. Conclusion The incidence of SLE is relatively rare. It tends to occur in patients with active lupus, especially in lupus nephritis and hematologic involvement. Glucocorticoids combined with immunosuppressants, as well as local treatment, could improve the prognosis. Key words: Lupus erythematosus, systemic; Bullous