Rowell syndrome

This is Rowell syndrome on the hands and face of a girl with systemic lupus erythematosus (SLE) (fig 1).bmj;378/jul20_7/e070553/F1F1f1Fig 1She presented with a two day history of fever, headache, and new lesions on the hands, neck, and face. She had a background of SLE for which she had been taking corticosteroids, azathioprine, and hydroxychloroquine for two years, but was taking no other medications. Examination revealed erythematous, annular, target-like papuloplaques on the hands, face, and neck with lip ulcers. Serological tests for mycoplasma, herpes simplex virus, cytomegalovirus, and Epstein-Barr virus were negative.The diagnosis of Rowell syndrome requires the presence of three major criteria: erythema multiforme-like targetoid lesions, histological and serological evidence of SLE, and a speckled pattern of anti-nuclear antibodies, all present in this patient. At least one of the minor criteria must also be present for diagnosis, including the presence of chilblains; anti-Ro(SS-A) (present in this patient) or anti-La(SS-B); and…
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