Systemic Lupus Erythematosus vs. Mixed Connective Tissue Disease Disguised As Scabies

Abstract

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that involves numerous body systems and may initially present as a malar or discoid rash. When there are features of other autoimmune disorders present, such as scleroderma or polymyositis, the term mixed connective tissue disorder (MCTD) may be used. The current literature illustrates that the diagnostic criteria for MCTD are unclear. Additionally, the literature presents cases of scabies mimicking the presentation of various autoimmune disorders with cutaneous manifestations. We introduce a case of a young African American female who developed a pruritic rash on her face, abdomen, hands, and scalp. An initial diagnosis of scabies was made, however, failed to improve after a course of permethrin 5% topical cream. Subsequently, she was hospitalized, and diagnosed with pancytopenia, cardiomyopathy, microscopic hematuria and trace proteinuria. Systemic lupus erythematosus/scleroderma overlap syndrome was later confirmed by serologic testing. The patient was started on corticosteroids, with resultant improvement in her symptoms and laboratory findings.