{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T14:31:56Z","timestamp":1764253916443,"version":"3.46.0"},"reference-count":14,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,3,26]],"date-time":"2024-03-26T00:00:00Z","timestamp":1711411200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:sec>\n                    <jats:title>Key Clinical Message<\/jats:title>\n                    <jats:p>Although it is very uncommon, SLE may initially present with recurrent episodes of EM\u2010like rash. Despite the various possibilities underlying their association, prompt identification, and treatment of SLE in patients presenting with EM is important to prevent death or serious organ damage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Abstract<\/jats:title>\n                    <jats:p>Rowell's syndrome (RS) is an uncommon presentation of systemic lupus erythematosus (SLE) with erythema multiforme (EM)\u2010like lesions associated with specific serological changes, including positive rheumatoid factor (RF), speckled antinuclear antibody (ANA), positive rheumatoid factor, or anti\u2010La antibodies in the serum. Our case, a 41\u2010year\u2010old 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. Classical 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\u2010steroid anti\u2010inflammatory 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. In this case report, the importance of considering SLE in patients presenting initially with recurrent episodes of EM\u2010like rash is emphasized. RS should be considered, especially when there is no evidence of triggering factors. Early diagnosis and prompt treatment of SLE are crucial to preventing death and irreversible organ damage.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ccr3.8677","type":"journal-article","created":{"date-parts":[[2024,3,26]],"date-time":"2024-03-26T23:49:29Z","timestamp":1711496969000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Systemic lupus erythematosus associated with erythema multiforme: A rare case report of Rowell's syndrome"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6382-1082","authenticated-orcid":false,"given":"Madhur","family":"Bhattarai","sequence":"first","affiliation":[{"name":"Maharajgunj Medical Campus, Institute of Medicine Tribhuvan University  Maharajgunj Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Niraj Kumar","family":"Sharma","sequence":"additional","affiliation":[{"name":"Sukraraj Tropical and Infectious Disease Hospital  Kathmandu Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-6214-3519","authenticated-orcid":false,"given":"Shreeram","family":"Paudel","sequence":"additional","affiliation":[{"name":"Maharajgunj Medical Campus, Institute of Medicine Tribhuvan University  Maharajgunj Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sujata","family":"Bhandari","sequence":"additional","affiliation":[{"name":"Nobel Medical College Teaching Hospital  Biratnagar Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amrit","family":"Bhusal","sequence":"additional","affiliation":[{"name":"BP Koirala Institute of Health Sciences  Dharan Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kiran","family":"Dhonju","sequence":"additional","affiliation":[{"name":"Sukraraj Tropical and Infectious Disease Hospital  Kathmandu Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7891-0333","authenticated-orcid":false,"given":"Sandip","family":"Kuikel","sequence":"additional","affiliation":[{"name":"Sukraraj Tropical and Infectious Disease Hospital  Kathmandu Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shivendra Kumar","family":"Jha","sequence":"additional","affiliation":[{"name":"Sukraraj Tropical and Infectious Disease Hospital  Kathmandu Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Egesh","family":"Aryal","sequence":"additional","affiliation":[{"name":"Nepalese Army Institute of Health Sciences  Kathmandu Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deepak","family":"Subedi","sequence":"additional","affiliation":[{"name":"Nepalese Army Institute of Health Sciences  Kathmandu Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,3,26]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.5070\/D3272052390"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2020-235173"},{"issue":"8","key":"e_1_2_13_4_1","first-page":"1","article-title":"Targetoid\u2010like lesions and chilblain\u2010like erythema manifested on hands and feet: a case of Rowell syndrome from China","volume":"11","author":"Li Y","year":"2023","journal-title":"Immunity, Inflamm 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