Generalised Blisters and Respiratory distress: A Case of Bullous Systemic Lupus Erythematosus

Mingyuan Ren,1,2,* Yijia He,1,* Jianzhong Zhang,3 Jinfang Zhang,1,2 Guoqiang Zhang1,2 1Department of Dermatology, the First Hospital of Hebei Medical University, Shijiazhuang, People’s Republic of China; 2Hebei Technical Innovation Center for Dermatology and Medical Cosmetology Technology, Shijiazhuang, People’s Republic of China; 3Department of Dermatology, Affiliated Hospital of Hebei University of Engineering, Handan, People’s Republic of China*These authors contributed equally to this workCorrespondence: Jinfang Zhang; Guoqiang Zhang, Email 58303110@hebmu.edu.cn; 57702800@hebmu.edu.cnAbstract: Tjalma’s syndrome is a benign combination of ascites, pleural effusion, and elevated CA-125 occurring in patients with systemic lupus erythematosus. Reports of Tjalma’s syndrome are scarce. An elevated CA-125 level often suggests the possibility of the presence of a malignant tumor. We report a case of generalised erythema and blisters with pruritus, massive unilateral pleural effusion and elevated CA-125. This patient was finally diagnosed with bullous systemic lupus erythematosus after exclusion of tumour and other maculopapular disorders. We hope that this particular case may provide a more comprehensive and novel diagnostic idea of systemic lupus erythematosus and pleural effusion, avoiding unnecessary anxiety, laboratory tests and surgical interventions.Keywords: systemic lupus erythematosus, bullous systemic lupus erythematosus, pleural effusion, Tjalma’s syndrome, CA-125