Lupus erythematosus with antiphospholipid syndrome and erythema multiforme-like lesions

A. V. Marzano, E. Berti, G. Gasparini, R. Caputo

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The occurrence of erythema multiforme (EM) in patients with lupus erythematosus (LE) has been described previously as a coincidental association. In contrast, LE with EM-like lesions and a peculiar immunological pattern, including positive rheumatoid factor, antinuclear antibodies and a serum antibody against an extract of human tissues recently recognized as similar to Ro (SSA), constitutes an established entity named Rowell's syndrome. We describe a woman with LE and long-standing widespread vesiculobullous and necrotic haemorrhagic EM-like lesions in combination with Ro (SSA) and scl-70 antibodies and the typical laboratory findings of the antiphospholipid syndrome (APS), namely lupus anticoagulant, anticardiolipin antibodies and prolonged activated partial thromboplastin time. This case could conceivably be consistent with a diagnosis of Rowell's syndrome, if the latter is regarded as a clinicopathological spectrum. However, the coexistence of LE, persistent EM-like disease and incomplete APS may also fulfil the diagnostic criteria for the 'multiple autoimmune syndromes'. We speculate that the laboratory markers of APS play a pivotal part in such an unusual clinical presentation.

Original languageEnglish
Pages (from-to)720-724
Number of pages5
JournalBritish Journal of Dermatology
Issue number4
Publication statusPublished - 1999


  • Antiphospholipid syndrome
  • Erythema multiforme
  • Lupus erythematosus
  • Multiple autoimmune syndromes
  • Rowell's syndrome

ASJC Scopus subject areas

  • Dermatology


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