Efficacy of intravenous immunoglobulins in a patient with systemic lupus erythematosus presenting with Stevens-Johnson syndrome.

To cite: VázquezSanabria IL, MercadoSeda R, Varela-Rosario N, et al. BMJ Case Rep Published online: [please include Day Month Year] doi:10.1136/bcr-2015211157 DESCRIPTION A 38-year-old woman with systemic lupus erythematosus (SLE) manifested by tiredness, polyarthritis, lymphopaenia, elevated antidouble-stranded DNA antibodies, and hypocomplementaemia was initiated on azathioprine and hydroxychloroquine. After 2 weeks of treatment, she developed extensive erythematous raised skin patches, facial oedema, and desquamation of nasal and oral mucosa. Both drugs were discontinued and she improved within 4–7 days. Since hydroxychloroquine is associated with more hypersensitivity reactions than azathioprine, the latter was reintroduced, but 2 days later, the patient developed severe recurrent skin lesions (figure 1A–C). Skin biopsy showed band-like lymphocytic infiltrate with focal vacuolar interface