Abstract
BACKGROUND: Diagnosing bullous eruptions in systemic lupus erythematosus (SLE) patients is challenging because there are so many differential diagnoses, including drug reactions such as Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN) and TEN-like cutaneous lupus erythematosus (LE). CASE PRESENTATION: An Indonesian female with a SLE history complained of an erythematous rash over the body 2 weeks ago. A pulse dose of methylprednisolone was given, and after 3 days, of getting bullae appeared all over the body and treatment stopped. The patient is treated in collaboration with dermatology, ophthalmology, and allergy consultants to obtain a diagnosis of SJS supporting skin biopsy. The patient was given methylprednisolone 62.5 mg once daily for 7 days, Gentamicin 80 mg twice daily, and the skin lesion was treated with NaCl 0.9% compression. The patient showed improvement and decreased methylprednisolone dose to 16 mg 3 times a day. DISCUSSION: Skin biopsy must be obtained to establish the diagnosis between JSJ/TEN and cutaneous LE. CONCLUSION: SJS/TEN can occur in SLE patients. The correct diagnosis can reduce the patient's mortality and morbidity.