Case Presentation A 47-year-old woman with a long-standing history of systemic lupus erythematosus (SLE), confirmed by positive ANA, anti-dsDNA, and anti-Smith antibodies, presented with a one-week history of a mildly pruritic, burning rash. Medical History Known case of systemic lupus erythematosus (SLE) On treatment with mycophenolate mofetil 1 g twice daily, prednisone 10 mg daily, and anifrolumab 300 mg IV every four weeks for disease control Initial Examination & Treatment Multiple erythematous, edematous wheals present on the trunk and proximal extremities (Cover Image A) Lesions were clinically indistinguishable from urticaria, with no evidence of purpura, post-inflammatory hyperpigmentation, or scarring She was initially treated with cetirizine 10 mg four times daily for suspected urticaria.
Despite this treatment, the rash showed minimal improvement, with persistent lesions…
