Rowell's syndrome: the challenge of diagnosing a heterogeneous entity

Abstract

Rowell's syndrome is a rare pathology characterized by coexistence of erythema multiforme-like lesions and lupus erythematosus associated with characteristic immunological markers. We present a case of a female patient with subacute cutaneous lupus erythematosus who manifested multiple erythemato-violaceous plaques with central hemorrhagic blister resembling erythema multiforme, located on the face, trunk and extremities. The presence of antinuclear antibodies 1/320, positivity for anti-Ro/SSA and rheumatoid factor, together with the histopathological findings, reached the diagnosis of Rowell's syndrome. We highlight how the criteria to define this entity are still heterogeneous and its diagnosis is difficult.