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Systemic Lupus Erythematosus. Presented by Lina S. Plantilla, MD (by invitation).
A 20-year-old South American man presented in September 1973 with acute onset of diffuse alopecia, weight loss, arthralgia, buccal mucosal erosions, and erythematous plaques over the butterfly area of the face and chest. Laboratory data showed the presence of anemia, leukopenia, thrombocytopenia, elevated erythrocyte sedimentation rate, a 4+ value in the direct Coombs test, albuminuria, cylinduria, a low serum complement, and 1:40 titer for a positive, speckled, antinuclear antibody test. A skin biopsy specimen from the face was characteristic of lupus erythematosus. Direct immunofluorescent staining done on involved and uninvolved skin, with anti-IgG, before treatment showed a strongly positive lumpy-bumpy pattern of fluorescence at the dermoepidermal junction. He was treated with 100 mg of prednisone daily for five weeks; subsequently, the dose was gradually reduced. At present, he is asymptomatic; laboratory values are normal; and he is on a
Lynfield YL. NEW YORK ACADEMY OF MEDICINE, SECTION ON DERMATOLOGY. Arch Dermatol. 1975;111(1):120. doi:10.1001/archderm.1975.01630130122018