Bullous systemic lupus erythematosus

Bullous systemic lupus erythematosus (BSLE) is rare heterogeneous cutaneous manifestation in patient with systemic lupus erythematosus (SLE). BSLE encompasses a subepidermal autoimmune bullous disease with type VII collagen autoantibodies, leading to epidermolysis bullosa acquisita in patients with SLE. Alternatively, an acute generalized hemorrhagic vesiculo-bullous eruption may also occur in patients with SLE caused by the extensive inflammatory reaction without the presence of type VII collagen. Vesicular eruptions can also be seen in subacute cutaneous lupus erythematosus due to severe inflammatory reaction with subepidermal clefting, which in extreme cases may resemble erythema multiforme (Rowell syndrome) or toxic epidermal necrolysis.