Rowell Syndrome: A True Entity or a Diagnostic Challenge?

Abstract

Lupus Erythematosus (LE) is an inflammatory condition of the connective tissue which manifests in variable forms. Rowell syndrome is a rare entity, with a female preponderance, where there is the presence of both LE and Erythema Multiforme (EM)-like lesions. Such patients are positive for antinuclear, anti-Ro/La and rheumatoid factor. Subcutaneous LE (SCLE) and EM can often share characteristics. The presence of lesions resembling both the conditions can pose a diagnostic difficulty, especially in the absence of complete clarity on the existence of Rowell syndrome. Present case is of a 47-year-old female, who presented with rashes over the face and trunk, along with photosensitivity. Cutaneous examination revealed multiple erythematous hyperpigmented plaques over the face with atypical targetoid lesions over the trunk and limbs. The diagnosis of Rowell’s syndrome was confirmed based on immunology and histopathology. This case has been reported to highlight the importance of delving into the various presentations of LE.