Transition of lupus erythematosus tumidus to systemic lupus erythematosus - case report and literature review

The transition of lupus erythematosus tumidus (LET) to systemic lupus erythematosus (SLE) is a rarity. We report the case of a 63-year-old female patient who presented to our dermatology outpatient clinic with a previously known LET and new skin lesions on the lower extremities. Serologic examinations showed a transition from ANA negativity to positive values, accompanied by elevated anti-dsDNA antibodies and decreased complement factors, thus fulfilling the criteria for SLE. In the present case, which was particularly challenging due to the extended treatment history and additional diseases, treatment with anifrolumab was chosen due to the progressive systemic clinical picture, in order to specifically control disease activity and suppress systemic manifestations. This case illustrates the importance of close follow-up of patients with LET, especially in the presence of risk factors, in order to identify a potential transition to SLE at an early stage and to take timely therapeutic measures.