Targetoid-like lesions and chilblain-like erythema manifested on hands and feet: A case of Rowell syndrome from China

Background: Rowell syndrome (RS) is an uncommon condition characterized by erythema multiforme (EM)-like lesions and lupus erythematosus. It is more common in females, and EM may be the first manifestation of the disease with positive autoantibodies, such as antinuclear antibody (ANA), SSA, SSB and rheumatoid factor. The pathogenesis of RS is unknown and is likely caused by drug induction, ultraviolet exposure and infection.Method: We describe a case of RS from China which presented as characteristic targetoid-like lesions and chilblain-like erythema on hands and feet. This is a case of RS in a female patient from the inpatient department of dermatology.Results: A 41-year-old female with systemic lupus erythematosus exhibited chilblain-like erythema and characteristic EM lesions on her extremities. She tested positive for serum ANA (1:320) and anti-double-stranded DNA, as well as other autoantibodies. Systemic glucocorticoids and hydroxychloroquine worked effectively for her.Conclusion: The present case met diagnostic criteria of RS. Notably, there was a co-occurrence of facial butterfly erythema, chilblain-like erythema and EM lesions distributed on the limbs in this case.

Automated summary

This case describes a female patient from China with Rowell syndrome, presenting with characteristic targetoid-like lesions and chilblain-like erythema on hands and feet. The patient tested positive for serum antinuclear antibody and other autoantibodies, suggesting a possible autoimmune etiology for RS. Treatment with glucocorticoids and hydroxychloroquine resulted in effective management of the disease.