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Bullous eruption in a patient with lupus erythematosus.

REPORT OF A CASE A 23-year-old woman was admitted to The Johns Hopkins Hospital, Baltimore, for evaluation of fever, polyarthralgias, and a skin rash. She had been well until four weeks before admission, when she developed pain in multiple small and large joints. After initial evaluation at an outside hospital two weeks before the present admission, she had been placed on a regimen of hydroxychloroquine sulfate (200 mg/d), indomethacin (75 mg/d), enteric-coated aspirin (1 g three times a day), and ampicillin (250 mg four times a day) for cough. Her symptoms progressed and she developed pleuritic chest pain, malaise, fever, headache, and a vesiculobullous eruption that prompted admission to our hospital. On physical examination, the patient had tense vesicles and bullae on a nonerythematous base scattered over her head and the upper aspect of her trunk; most of the lesions were concentrated on the lips, postauricular area, and axilla (Figs