{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T08:28:53Z","timestamp":1787646533538,"version":"build-2736575974"},"reference-count":22,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2024,3,18]],"date-time":"2024-03-18T00:00:00Z","timestamp":1710720000000},"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":["Int J Surg Pathol"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:p>\n                    <jats:italic toggle=\"yes\">Background.<\/jats:italic>\n                    Fixed drug eruption and Rowell syndrome stand as intriguing entities with overlapping clinical and pathological features.\n                    <jats:italic toggle=\"yes\">Case Presentation<\/jats:italic>\n                    . A 32-year-old female patient presented with a tender and pruritic rash on the left upper chest for 3 days. Clinical examination revealed a flaring rash on the chest, under her left eye, tongue, and lips. The patient had a significant past medical history of systemic lupus erythematous with positive (ANA, Sm, dsDNA, ribosomalP, RNP) antibodies, hypocomplementemia, inflammatory arthritis, discoid lupus, leukopenia, thrombocytopenia, and immune thrombocytopenic purpura, and avascular necrosis affecting both hips and her right knee. At the time of presentation, the patient was on azathioprine 150\u2005mg daily and hydroxychloroquine 200\u2005mg twice daily. Skin biopsy of the left upper chest revealed interface dermatitis with necrotic keratinocytes at the dermal-epidermal junction. Superficial and, in some areas, deep perivascular and peri adnexal lymphocytic infiltrates were observed, accompanied by eosinophils. CD123 staining highlighted 16% of the inflammatory cells. Direct Immunofluorescence for IgG, IgA, IgM, C3, and fibrinogen revealed positive linear basement membrane staining for IgG and fibrinogen, with no significant staining for the remaining immunoreactants. Considering the patient's history of medicine usage, and negative SS-A and SS-B antibody, a fixed drug eruption was favored.\n                    <jats:italic toggle=\"yes\">Discussion<\/jats:italic>\n                    . This article discusses the clinical presentations, pathophysiological mechanisms, and diagnostic criteria for fixed drug eruption and Rowell syndrome.\n                    <jats:italic toggle=\"yes\">Conclusion.<\/jats:italic>\n                    Awareness of the distinct clinical and histopathologic features of fixed drug eruption and Rowell syndrome, particularly when sharing cutaneous manifestations, underscores the importance of a comprehensive diagnostic approach and laboratory testing.\n                  <\/jats:p>","DOI":"10.1177\/10668969241234316","type":"journal-article","created":{"date-parts":[[2024,3,18]],"date-time":"2024-03-18T03:29:43Z","timestamp":1710732583000},"page":"1485-1490","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Erythema Multiforme-Like Fixed Drug Eruption During Azathioprine and Hydroxychloroquine Treatment for Systemic Lupus Erythematosus Mimicking Rowell Syndrome: A Rare and Challenging Clinical Scenario"],"prefix":"10.1177","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6145-256X","authenticated-orcid":false,"given":"Nada","family":"Shaker","sequence":"first","affiliation":[{"name":"The Ohio State University Wexner Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar P.","family":"Sangueza","sequence":"additional","affiliation":[{"name":"Wake Forest University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nuha","family":"Shaker","sequence":"additional","affiliation":[{"name":"University of Pittsburgh Medical Center Health System"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan","family":"Arthur","sequence":"additional","affiliation":[{"name":"University of Nebraska Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dinesh","family":"Pradhan","sequence":"additional","affiliation":[{"name":"University of Nebraska Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,3,18]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00296-010-1623-y"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/mrcr\/rxab013"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.5070\/D3272052390"},{"issue":"1","key":"e_1_3_2_5_2","article-title":"Rowell syndrome","volume":"5","author":"Bhat RY","year":"2014","unstructured":"Bhat RY, Varma C, Bhatt S, Balachandran C. Rowell syndrome. Indian Dermatol Online J. 2014;5(Suppl 1):S33-S35. doi:https:\/\/doi.org\/10.4103\/2229-5178.144526","journal-title":"Indian Dermatol Online J"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.5070\/D35PF8K3R2"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.5114\/ada.2023.130514"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.5070\/D32SV231H1"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2133.2000.03306.x"},{"key":"e_1_3_2_10_2","doi-asserted-by":"crossref","unstructured":"Andronache: Rowell syndrome-a controversial clinical entity - Google Scholar. Accessed October 29 2023. https:\/\/scholar.google.com\/scholar_lookup?journal=Rom+J+Rhematol&title=Rowell+syndrome-a+controversial+clinical+entity&author=IT+Andronache&author=C+Suta&author=C+Ionescu&author=A+Calistrat&author=M+Suta&volume=24&publication_year=2015&pages=230-234&","DOI":"10.37897\/RJR.2015.4.8"},{"issue":"2","key":"e_1_3_2_11_2","first-page":"381","article-title":"Possible progression of subacute lupus erythematosus\u2013case report","volume":"118","author":"Br\u0103ni\u015fteanu DE","year":"2014","unstructured":"Br\u0103ni\u015fteanu DE, L\u0103bon\u0163u A, Ciobanu D, Stoleriu G, Br\u0103ni\u015fteanu D, Oan\u0163\u0103 A. Possible progression of subacute lupus erythematosus\u2013case report. Rev Med Chir Soc Med Nat Iasi. 2014;118(2):381-386.","journal-title":"Rev Med Chir Soc Med Nat Iasi"},{"key":"e_1_3_2_12_2","unstructured":"Rowell\u2019s syndrome induced by terbinafine - PubMed. 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