Severe Cutaneous Eruption in a Woman After Ingesting Multiple Drugs: A Rare Presentation of Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis-Like Lupus Erythematosus

Toxic epidermal necrolysis-like lupus erythematosus (TEN-LE) is a very rare variant of LE, which is characterized by extensive areas of epidermal necrolysis indistinguishable from drug induced Stevens-Johnson syndrome (SJS)/TEN. Here, we describe an unusual presentation of LE, in whom acute epidermal necrolysis was the initial diagnostic manifestation of LE. Our patient fulfilled the criteria for a definite diagnosis of systemic LE, in addition she had a history of recent exposure to multiple drugs, some of which are known to cause SJS/TEN and some of which are known to cause drug-induced subacute cutaneous LE. This case report not only discloses an exceptional presentation of SJS/TEN-like LE, but also questions the underlying pathogenic mechanisms of LE.