Uploaded August 2026 | Updated September 2026, 2 weeks ago
A 33-year-old man with systemic lupus erythematosus presented with a 1-week history of pruritic, burning plaques. Examination showed pink, edematous plaques on the hands, elbows, knees, and feet. Laboratory testing showed elevated antinuclear and anti–double-stranded DNA antibody levels and low complement levels. Skin biopsy showed leukocytoclastic vasculitis. Treatment with oral and topical glucocorticoids was started. One week later, the lesions evolved into fixed, urticarial, annular, and targetoid plaques with rims of purpura on the thighs, chest, abdomen, and back. What is the most likely diagnosis? Submit your answer at NEJM.org (link in bio).
#nejm
A 33-year-old man with systemic lupus erythematosus presented with a 1-week history of pruritic, burning plaques. Examination showed pink, edematous plaques on the hands, elbows, knees, and feet. Laboratory testing showed elevated antinuclear and anti–double-stranded DNA antibody levels and low complement levels. Skin biopsy showed leukocytoclastic vasculitis. Treatment with oral and topical glucocorticoids was started. One week later, the lesions evolved into fixed, urticarial, annular, and targetoid plaques with rims of purpura on the thighs, chest, abdomen, and back. What is the most likely diagnosis? Submit your answer at NEJM.org (link in bio).
#nejm
