SLE (HANDS)

Diagnosis: SLE (HANDS)

Case submitted by Dr.Azeem Alam Khan to the dermRounds community.

Clinical Presentation

Clinical photograph(s) submitted for peer review and discussion.

Clinical History

Submitted by Dr.Azeem Alam Khan. Originally posted September 29, 2009.

Treatment

See case discussion.

Differential Diagnosis

• Drug eruption • Rubella • Erythema infectiosum • Roseola • Scarlet fever • Kawasaki disease • Infectious mononucleosis with ampicillin rash

Key Learnings

• Classic triad: cough, coryza, conjunctivitis (the 3 C's) preceding rash • Koplik spots: pathognomonic — white-blue papules on buccal mucosa opposite molars • Morbilliform (brick-red) rash starts on face, spreads cephalocaudally • Highly contagious — basic reproduction number (R0) of 12-18 • Complications: pneumonia (leading cause of death), encephalitis, SSPE (years later) • Immunosuppression during and after measles — increased susceptibility to secondary infections

Tags: sle, hands, dr.azeem alam khan