Rapid onset of systemic lupus erythematosus with rarely observed cutaneous lesions

Introduction
Systemic lupus erythematosus is a multi-organ connective tissue disease of heterogeneous clinical presentation.

Objective
This article presents a case of a fulminant disease in a woman in which acute cutaneous lesions preceded multi-organ dysfunction, including acute kidney injury.

Case Report
Papular eruptions demonstrating a tendency to exudate and formation of erosions appeared on the patient’s facial skin. Erosions were present on oral mucosa, and maculopapular lesions developed on thighs. Lesions were accompanied by high fever, general malaise and pain of muscles and joints. Haematological and immunological abnormalities as well as a decrease in kidney function were observed. A rapid development of systemic lupus erythematosus was diagnosed an the treatment with glucocorticosteroids, cyclophosphamide, plasmapheresis and haemodialysis was introduced, resulting in remission.

Conclusions
Acute onset of systemic lupus erythematosus often imitates an infectious disease. Presence of cutaneous lesions typical for systemic lupus erythematosus allows early diagnosis and introduction of appropriate treatment.