I am seeing a44yowf with diabetes, SLE, and end-stage renal failure who has been on peritoneal dialysis for 2 yrs.
Lesions are bright red and peeling superficially like pemphigus foliaceus.
Lesioanal histology is consistent with acute LE, and perilesional Direct IF is negative. Bacterial cultures are negative. Just called to a hospital consult of a 62 yo wf with diagnosis of RA in 1961 and Sjogren's 1986. She started developing facial photosensitive rash 5 years ago. All lupus blood tests have been negative and a biopsy of involved facial skin by a Derm.