{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T21:07:20Z","timestamp":1777928840312,"version":"3.51.4"},"reference-count":14,"publisher":"SAGE Publications","issue":"14","license":[{"start":{"date-parts":[[2020,8,25]],"date-time":"2020-08-25T00:00:00Z","timestamp":1598313600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Lupus"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>In the GLADEL cohort, the bullous lupus (BSLE) prevalence was 0.41%. However, literature on pediatric BSLE is scarce. This study described the clinical, histological, and immunological characteristics and the treatment response in a series of children with BSLE as the first clinical manifestation of pediatric SLE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The clinical, histological, and immunological characteristics of a series of 5 cases of BSLE between 2010-2019 from two reference centers in Colombia were analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>All cases had bullous lesions that resolved with residual hypopigmentation. One had a focal seizure, and another arthritis with thrombocytopenia. Two had transient proteinuria with normal urinalysis. Anti-nuclear antibody titers ranged from 1:160 to 1:2560, and four were anti-dsDNA (+). Five patients had anti-RNP antibodies, and four anti-Sm antibodies. All had low C3, and 80% low C4 counts; 80% had erythrocyte sedimentation rate (ESR) \u226520\u2009mm\/hour and 60% had C-reactive protein (CRP) \u22650.5\u2009mg\/dL. All patients responded to glucocorticoids and dapsone. Histology reports and direct immunofluorescence (DIF) test showed subepidermal blisters with neutrophils in the papillary dermis and linear deposits of Igs\/complement proteins in 80% of the skin biopsies. IgG\/IgM was present in 5 samples. IgA was positive in 60% and C3 in 80%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this pediatric series, BSLE tends to have a monophasic behavior associated with neuropsychiatric, skeletal, and hematological involvement in 40% of the patients, and with good prognosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0961203320950814","type":"journal-article","created":{"date-parts":[[2020,8,26]],"date-time":"2020-08-26T02:14:33Z","timestamp":1598408073000},"page":"1937-1942","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":9,"title":["Bullous lupus as the first manifestation of systemic lupus erythematosus in the pediatric population: A diagnostic challenge in daily practice"],"prefix":"10.1177","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0385-8160","authenticated-orcid":false,"given":"Fabio Andr\u00e9s","family":"Torres Saavedra","sequence":"first","affiliation":[{"name":"Rheumatology Group GRUA, Department of Internal Medicine, Facultad de Medicina, Universidad de Antioquia, Medell\u00edn, Colombia"},{"name":"Hospital Universitario San Vicente Fundaci\u00f3n, Medell\u00edn, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lyna Ramirez","family":"Campo","sequence":"additional","affiliation":[{"name":"Rheumatology Group GRUA, Department of Internal Medicine, Facultad de Medicina, Universidad de Antioquia, Medell\u00edn, Colombia"},{"name":"Hospital Universitario Fundaci\u00f3n Valle del Lili, Cali, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monica Velasquez","family":"Mendez","sequence":"additional","affiliation":[{"name":"Rheumatology Group GRUA, Department of Internal Medicine, Facultad de Medicina, Universidad de Antioquia, Medell\u00edn, Colombia"},{"name":"Hospital Universitario San Vicente Fundaci\u00f3n, Medell\u00edn, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natalia Mejia","family":"Barreneche","sequence":"additional","affiliation":[{"name":"Hospital Universitario San Vicente Fundaci\u00f3n, Medell\u00edn, Colombia"},{"name":"Dermatological Research Center CIDERM, Service of Dermatology, Facultad de Medicina, Universidad de Antioquia, Medell\u00edn, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3638-3771","authenticated-orcid":false,"given":"Gloria Andrea Vargas","family":"Suaza","sequence":"additional","affiliation":[{"name":"Hospital Universitario San Vicente Fundaci\u00f3n, Medell\u00edn, Colombia"},{"name":"Dermatological Research Center CIDERM, Service of Dermatology, Facultad de Medicina, Universidad de Antioquia, Medell\u00edn, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2370-2916","authenticated-orcid":false,"given":"Juan David Ruiz","family":"Restrepo","sequence":"additional","affiliation":[{"name":"Hospital Universitario San Vicente Fundaci\u00f3n, Medell\u00edn, Colombia"},{"name":"Dermatological Research Center CIDERM, Service of Dermatology, Facultad de Medicina, Universidad de Antioquia, Medell\u00edn, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6593-4275","authenticated-orcid":false,"given":"Manuel","family":"Martinez-Gomez","sequence":"additional","affiliation":[{"name":"Hospital Universitario San Vicente Fundaci\u00f3n, Medell\u00edn, Colombia"},{"name":"Dermatological Research Center CIDERM, Service of Dermatology, Facultad de Medicina, Universidad de Antioquia, Medell\u00edn, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2020,8,25]]},"reference":[{"key":"bibr1-0961203320950814","doi-asserted-by":"publisher","DOI":"10.1177\/0961203307088006"},{"key":"bibr2-0961203320950814","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2018.00144"},{"key":"bibr3-0961203320950814","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcl.2012.03.007"},{"key":"bibr4-0961203320950814","first-page":"4","volume":"12","author":"Aguilar NS","year":"2016","journal-title":"Archivos de 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