Unusual presentation of childhood Systemic Lupus Erythematosus

Mycophenolate Mofetil and Erythromycin for Bullous Lupus Erythematosus of Childhood

Background:

Bullous lupus erythematosus is a rare disease that is extremely rare in childhood (with only seven previous reports) and difficult to control.

Objective:

Herein is presented the youngest patient reported with this condition, and a novel, safe, and effective treatment regimen is described.

Methods:

Through study, perseverance, serendipity, and creativity, a safe and effective regimen was developed.

Results:

The combination of mycophenolate mofetil and erythromycin (plus sun protection) was found to be efficacious.

Conclusion:

It is proposed that the two medications act synergistically, with the “antibiotic” acting as a antiinflammatory agent, but at a different point in the inflammatory cascade than mycophenolate mofetil. This suggests the approach of using common, inexpensive, and benign antibiotics to potentiate, and perhaps decrease the use of, immunomodulatory agents in autoimmune and autoinflammatory diseases.

Bullous lesions as a manifestation of systemic lupus erythematosus in two Mexican teenagers

Rarely, systemic lupus erythematosus (SLE) presents with bullous lesions due to severe edema and hydropic degeneration of the basal layer, or as a subepidermal blistering disease. Here, we describe two Mexican teenagers, one with SLE with blisters and another with bullous SLE. We also discuss the mechanisms and clinical implications of lesion formation in patients with SLE and bullae.

Bullous lupus: an unusual initial presentation of systemic lupus erythematosus in an adolescent girl

Bullous systemic lupus erythematosus is a subepidermal blistering disease that occurs only rarely in a subset of patients with systemic lupus erythematosus and even less commonly in pediatric patients. Autoimmunity in bullous systemic lupus erythematosus is characterized by the presence of circulating anti-type VII collagen antibodies. We report here a case of a child whose initial systemic lupus erythematosus presentation was a diffuse bullous eruption.