Skin manifestations are not uncommon in subacute bacterial endocarditis (SBE). Of these the Osler nodules are well known, but others such as petechiae and disseminated papular or papulohemorrhagic skin lesions do occur from time to time. These skin manifestations may be helpful in establishing the diagnosis in otherwise doubtful cases.
Three years ago, however, we observed a patient in whom the skin lesions at first misguided us, but ultimately provided a strong argument in favor of the diagnosis subacute bacterial endocarditis.
These skin manifestations were of an unusual nature and were primarily located on the cheeks and earlobes, and at first a diagnosis of systemic lupus erythematosus (SLE) was strongly considered.
Because of the unusual nature of the skin lesions and also because of the possibility that they may be mistaken by others for skin lesions in systemic lupus erythematosus which may then lead to a wrong method of treatment,
RUITER M, MANDEMA E. New Cutaneous Syndrome in Subacute Bacterial Endocarditis. Arch Intern Med. 1964;113(2):283-290. doi:10.1001/archinte.1964.00280080119021