Bullous Systemic Lupus Erythematosus (BSLE) Differential Diagnoses

Updated: Oct 07, 2021
  • Author: Sarah Sweeney Pinney, MD, FAAD; Chief Editor: Dirk M Elston, MD  more...
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Diagnostic Considerations

The clinical, histologic, and immunohistochemical features of bullous systemic lupus erythematosus can resemble epidermolysis bullosa acquisita (the inflammatory form more often than the classic mechanobullous form), dermatitis herpetiformis, and bullous pemphigoid.

Toxic epidermal necrolysis–like lupus erythematosus demonstrates clinical and histologic overlap with drug-induced toxic epidermal necrolysis and toxic epidermal necrolysis–like variants of acute graft versus host disease and pseudoporphyria. Usually these cases have a previous history of SLE, as well as serologic markers for SLE, and lack a history of drug ingestion. [32] A similar clinical presentation is occasionally observed in patients with fulminant linear IgA bullous dermatosis (especially the drug-induced variety).

Differential Diagnoses