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Table 1 Clinical and Histological features of Stevens-Johnson syndrome (SJS) and subacute cutaneous lupus erythematosus (SCLE)

From: Drug-induced subacute cutaneous lupus erythematosus associated with docetaxel chemotherapy: a case report

  Stevens – Johnson syndrome (SJS) Subacute cutaneous lupus erythematosus (SCLE) Case commentary
Clinical features • Mostly drug-related • May be idiopathic or drug-induced Although the rapidity and severity of symptom progression favored a working diagnosis of SJS, on clinical grounds it was not possible to distinguish between SJS and SCLE in the case presented
  • Characterized as dusky erythematous lesions; lesions tend to be isolated but can have confluence on the face and trunk • Characterized as erythematous, papulosquamous or polycyclic annular plaques, typically non-scarring  
  • Typically involves the trunk, back, and extremities including palms and soles, neck, and face; often associated with painful mucosal surfaces • Typically consists of photosensitive regions with lesions confined to sun-exposed skin (upper trunk/back, shoulders, extensor arms, neck, lateral aspects of face) with mid-facial sparing  
  • Usually occurs within 7 to 21 days after initiation of the causative drug • Latent period between drug administration and the appearance of symptoms can range from several weeks to several years (in drug-induced SCLE)  
Histological features • In early lesions, apoptotic keratinocytes are observed scattered in the supra-basal layers of the epidermis • Epidermal changes and a superficial lymphocytic infiltrate in the upper dermis with apoptotic keratinocytes Histological findings of an interface dermatitis with dermal mucin deposition is most consistent with a diagnosis of SCLE
  • In late stages, a sub-epidermal blister with overlying confluent necrosis of the entire epidermis and spare peri-vascular infiltrate composed primarily of lymphocytes is seen • Dermal mucin deposits are commonly identified