IntroductionRowell's syndrome (RS) is an uncommon presentation of systemic lupus erythematosus (SLE) with erythema multiforme (EM)-like lesions associated with specific serological changes, including positive rheumatoid factor (RF), speckled anti-nuclear antibody (ANA), positive rheumatoid factor, or anti-La antibodies in the serum. Case PresentationOur case, a 41-year-old male, presented with features of EM.Upon investigation, we identified underlying systemic lupus erythematosus, marking a rare instance of SLE presenting for the first time as EM. Case DiscussionClassical or true EM is precipitated by trigger factors such as infective agents like the herpes simplex virus, Mycoplasma pneumoniae, drugs like anticonvulsants, antibiotics, and non-steroid anti-inflammatory drugs, any underlying malignancy, or connective tissue disorders, and is not associated with any specific serological abnormalities.EM cases associated with LE lesions where an EM trigger factor is missing are considered an RS diagnostic criterion. ConclusionIn this case report, the importance of considering RS as a differential diagnosis in all patients with LE exhibiting EM-like lesions is emphasized, especially when there is no evidence of triggering factors.Early diagnosis and prompt treatment are crucial to preventing complications.
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