{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T21:00:04Z","timestamp":1760043604477,"version":"3.44.0"},"reference-count":14,"publisher":"BMJ","issue":"10","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,9,28]]},"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:p>Specific vesiculobullous skin lesions in lupus erythematosus (LE) are rare and must be differentiated from toxic epidermal necrolysis (TEN), TEN-like dermatoses and other vesiculobullous conditions. We report a patient with typical subacute cutaneous lupus erythematous that progressed with large sheet-like areas of epidermal detachment and Nikolsky sign resembling TEN. She had a serological profile suggestive of underlying connective tissue disease, histological findings of interface dermatitis with a lymphocytic infiltrate, positive direct immunofluorescence, resolution with immunomodulation and lack of a culprit drug, features observed in TEN-like cutaneous lupus erythematous. Furthermore, she was diagnosed with lung carcinoma, an association that has been previously reported. Differentiating a bullous eruption in the context of pre-existing LE remains difficult requiring a thorough analysis of clinical and histopathological data.<\/jats:p>","DOI":"10.1136\/bcr-2019-231152","type":"journal-article","created":{"date-parts":[[2019,10,14]],"date-time":"2019-10-14T05:39:13Z","timestamp":1571031553000},"page":"e231152","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Toxic epidermal necrolysis-like subacute cutaneous lupus erythematosus associated with lung carcinoma"],"prefix":"10.1136","volume":"12","author":[{"given":"Lu\u00eds","family":"Santiago","sequence":"first","affiliation":[{"name":"Department of Dermatology, Hospital and University Centre of Coimbra, Coimbra, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rosa","family":"Mascarenhas","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Hospital Distrital da Figueira da Foz, Figueira da Foz, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u00d3scar","family":"Tellechea","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Hospital and University Centre of Coimbra, Coimbra, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margarida","family":"Gon\u00e7alo","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Hospital and University Centre of Coimbra, Coimbra, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,10,13]]},"reference":[{"key":"2025082706470305000_12.10.e231152.1","doi-asserted-by":"publisher","DOI":"10.1191\/0961203304lu2037sa"},{"key":"2025082706470305000_12.10.e231152.2","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1007\/s12016-017-8654-z","article-title":"Current perspectives on Stevens-Johnson syndrome and toxic epidermal necrolysis","volume":"54","author":"Lerch","year":"2018","journal-title":"Clin Rev Allergy Immunol"},{"key":"2025082706470305000_12.10.e231152.3","doi-asserted-by":"publisher","DOI":"10.1177\/0961203313492242"},{"key":"2025082706470305000_12.10.e231152.4","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2011.10705.x"},{"key":"2025082706470305000_12.10.e231152.5","doi-asserted-by":"publisher","DOI":"10.1038\/sj.jid.5701033"},{"key":"2025082706470305000_12.10.e231152.6","doi-asserted-by":"publisher","DOI":"10.1038\/clpt.2009.252"},{"key":"2025082706470305000_12.10.e231152.7","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2133.2000.03306.x"},{"key":"2025082706470305000_12.10.e231152.8","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1007\/s40257-014-0098-0","article-title":"Bullous systemic lupus erythematosus: a review and update to diagnosis and treatment","volume":"15","author":"Contestable","year":"2014","journal-title":"Am J Clin Dermatol"},{"key":"2025082706470305000_12.10.e231152.9","doi-asserted-by":"crossref","unstructured":"Romero LS , Bari O , Forbess CJ , et al . 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