Bullae in Systemic Lupus Erythematosus

Abstract

While the transient appearance of vesicles in the skin of patients with systemic lupus erythematosus has been amply documented,^1-6 little attention has been called to the occurrence of giant bullae as a manifestation of the disease. The classical lesion of systemic lupus in the skin is macular, erythematous, and only rarely leads to vesicle, bleb formation, or crusting.⁷ Indeed, while the mucous membrane lesions are felt perhaps to originate in vesicles,⁶ the skin ulcerations occasionally seen in patients with systemic lupus have rarely been attributed to such primary vesiculation.² The occurrence of bullous lesions is noted in most large series of observations,^2,4,6 but such lesions have not been reported to dominate the cutaneous manifestations in any given case. Recently we have seen 2 patients, in whose clinical picture giant bullae leading to ulceration and scarification were the predominant skin lesions. Report of Cases Case 1.—