Stevens–Johnson Syndrome-like Presentation of Systemic Lupus Erythematosus: A Case Report

Prerna N Patel; Dimpal V Patel; Dhruvi Jansari

doi:10.5005/jihr-11055-0019

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Stevens–Johnson Syndrome-like Presentation of Systemic Lupus Erythematosus: A Case Report

Prerna N Patel, Dimpal V Patel, Dhruvi Jansari

Keywords : Case report, Stevens–Johnson syndrome, Systemic lupus erythematosus, Toxic epidermal necrolysis

Citation Information : Patel PN, Patel DV, Jansari D. Stevens–Johnson Syndrome-like Presentation of Systemic Lupus Erythematosus: A Case Report. 2025; 2 (2):69-71.

DOI: 10.5005/jihr-11055-0019

License: CC BY-NC 4.0

Published Online: 30-04-2026

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Abstract

Aim and background: Systemic lupus erythematosus (SLE) can rarely present with Stevens–Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN)-like skin manifestations, causing a diagnostic challenge. Case description: We report a 20-year-old female with a history of discoid lupus erythematosus who presented with widespread erythematous to purpuric macules over the skin, malar rash, facial edema, hemorrhagic crusting over the lips, and mucosal ulcers without recent drug exposure. Laboratory tests showed pancytopenia, positive antinuclear antibody (ANA) profile, and liver dysfunction. Skin biopsy revealed early lupus changes. The patient improved significantly with intravenous methylprednisolone pulse therapy and supportive care. Conclusion: The subacute clinical course, photodistribution of skin lesions, limited mucosal involvement, positive ANA profile, and prompt response to corticosteroid therapy collectively support a diagnosis of SJS/TEN-like presentation of SLE rather than classic drug-induced TEN. Clinical significance: This case underscores the importance of recognizing SJS/TEN-like presentation of SLE for accurate diagnosis and prompt, effective management.

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