{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T00:28:04Z","timestamp":1767140884058,"version":"3.48.0"},"reference-count":15,"publisher":"BMJ","issue":"12","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,12,11]]},"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:p>We report a case of severe subacute cutaneous lupus erythematosus (SCLE) in a patient with Whipple\u2019s disease involving the gastrointestinal and cardiac systems and chronic hepatitis B with undetectable viral load. Cutaneous lesions consistent with SCLE developed shortly after the diagnosis of Whipple\u2019s disease, with extensive involvement of the trunk and limbs and marked photosensitivity. Histopathology revealed interface dermatitis. Direct immunofluorescence on lesional skin showed linear fibrinogen and discontinuous granular IgM deposits at the dermo-epidermal junction. Autoimmune testing demonstrated antinuclear antibody &gt; 1:320 with a nuclear speckled and multiple nuclear dots pattern, along with anti-SSA (Ro) and anti-sp100 positivity. The patient was treated with doxycycline, high-dose hydroxychloroquine and prednisone, resulting in significant clinical improvement within 1\u2009month.<\/jats:p>","DOI":"10.1136\/bcr-2025-268736","type":"journal-article","created":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T18:05:21Z","timestamp":1767117921000},"page":"e268736","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Subacute cutaneous lupus erythematosus in a patient with Whipple\u2019s disease"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-2020-0604","authenticated-orcid":false,"given":"Gabriele","family":"Zanardi","sequence":"first","affiliation":[{"name":"Dermatology, IRCCS San Martino Polyclinic Hospital Dermatology Department, Genoa, Liguria, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giulia","family":"Merlo","sequence":"additional","affiliation":[{"name":"Dermatology, IRCCS San Martino Polyclinic Hospital Dermatology Department, Genoa, Liguria, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emanuele","family":"Cozzani","sequence":"additional","affiliation":[{"name":"Dermatology, IRCCS San Martino Polyclinic Hospital Dermatology Department, Genoa, Liguria, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberto","family":"Russo","sequence":"additional","affiliation":[{"name":"IRCCS San Martino Polyclinic Hospital Dermatology Department, Genoa, Liguria, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,12,30]]},"reference":[{"key":"2025123016251056000_18.12.e268736.1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2011.10272.x."},{"key":"2025123016251056000_18.12.e268736.2","unstructured":"DermNet NZ . 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Whipple disease. Available: https:\/\/dermnetnz.org\/topics\/whipple-disease [Accessed 30 Apr 2025]."},{"key":"2025123016251056000_18.12.e268736.12","doi-asserted-by":"crossref","DOI":"10.7554\/eLife.32340","article-title":"Inherited IRF4 deficiency in a family with Whipple\u2019s disease","volume":"7","author":"Raphael","year":"2018","journal-title":"Elife"},{"key":"2025123016251056000_18.12.e268736.13","article-title":"Genetic susceptibility to Whipple\u2019s disease is associated with NOD2 polymorphisms","volume":"14","author":"Guerrero","year":"2023","journal-title":"Front Immunol"},{"key":"2025123016251056000_18.12.e268736.14","first-page":"161","article-title":"The clinical spectrum of anti-Ro (SSA) autoantibodies","volume":"66","author":"Lee","year":"1987","journal-title":"Scand J Rheumatol Suppl"},{"key":"2025123016251056000_18.12.e268736.15","doi-asserted-by":"crossref","DOI":"10.1177\/1759720X211073001","article-title":"Hydroxychloroquine in systemic lupus erythematosus: overview of current knowledge","volume":"14","author":"Dima","year":"2022","journal-title":"Ther Adv Musculoskelet Dis"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-268736","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T00:25:22Z","timestamp":1767140722000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-268736"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12]]},"references-count":15,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2025,12,30]]},"published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1136\/bcr-2025-268736"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-268736","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2025,12]]}}}