TY  - CHAP
M1  - Book, Section
TI  - Lupus: Systemic and Cutaneous
A1  - Pye, Allison
A1  - Mayeaux, Jr., E.J.
A1  - Mishra, Vineet
A1  - Usatine, Richard P.
A2  - Usatine, Richard P.
A2  - Smith, Mindy A.
A2  - Mayeaux, Jr., E.J.
A2  - Chumley, Heidi S.
PY  - 2019
T2  - The Color Atlas and Synopsis of Family Medicine, 3e
AB  - A  22-year-old  woman  presents  with  a  red  rash  on  her  face,  chest,  upper  arms,  and  thighs  for  the  past  6  days  (Figures  188-1  and  188-2).  She  had  been  diagnosed  with  systemic  lupus  erythematosus  (SLE)  5  years  ago  but  has  never  had  a  skin  rash  like  this  before.  This  rash  had  some  itching  associated  with  it  but  was  otherwise  asymptomatic.  Her  original  SLE  diagnosis  was  made  at  age  17  when  she  presented  with  a  deep  venous  thrombosis.  Six  days  ago  she  was  in  the  sun  for  an  extended  period  of  time  while  cycling.  Later  that  day  the  rash  became  very  red  on  her  face  and  upper  arms.  She  was  given  a  Medrol  Dosepak  in  a  local  urgent  care  without  any  benefit.  She  was  experiencing  fatigue  but  no  fever  or  other  systemic  symptoms.  Laboratory  testing  showed  a  very  high  antinuclear  antibody  (ANA)  with  a  white  blood  cell  count  of  1.1.  The  patient  was  referred  to  rheumatology  and  dermatology.  They  started  her  on  prednisone  60  mg  daily,  as  a  Medrol  Dosepak  has  insufficient  prednisolone  for  this  severe  flare  of  acute  cutaneous  lupus.  The  hydroxychloroquine  of  400  mg  daily  was  continued,  but  her  azathioprine  was  discontinued  to  make  sure  it  was  not  responsible  for  the  low  white  blood  cell  count.  The  following  week  the  patient's  skin  and  fatigue  were  much  improved.  In  reviewing  her  SLE  diagnosis,  she  met  8  of  11  criteria  for  SLE  (see  Table  188-1).  
SN  - 
PB  - McGraw-Hill Education
CY  - New York, NY
Y2  - 2024/04/19
UR  - accessmedicine.mhmedical.com/content.aspx?aid=1164362178
ER  -