Rowell's Syndrome: A Case Report and Literature Overview

Rowell Syndrome: A Comprehensive Review on Pathogenesis of a Rare and Challenging Entity and the Horizon of Targeted Therapeutics

Background

Rowell syndrome (RS), an infrequent illness characterized by a combination of erythema multiforme-like manifestations and systemic lupus erythematosus, poses diagnostic and clinical issues to the healthcare system. Initially discovered by Dr. Virginie Rowell in 1963, the disorder manifests as an overlapping illness with various dermatological and rheumatological conditions, necessitating precise assessment.

Method

The review encompasses demographic characters, dermatological signs and symptoms, triggering or contributing factors, laboratory studies, diagnosis and therapy challenges, and the outcome of RS. Through an analysis of the literature, this study identifies sunlight, medication use, COVID-19 vaccination, and bacterial infections as contributing predisposing risks. Laboratory abnormalities revealed positive antinuclear antibodies and rheumatoid factor as common features, supporting the autoimmune origin of this illness.

Result

Medications vary, with systemic corticosteroids used as the initial therapy, and appropriate proper outcomes are observed with rituximab and hydroxychloroquine. Recent discoveries in biological agents and targeted immunotherapies have provided useful options for personalized care.

Conclusion

In summary, our study provides detailed and valuable data to deepen our knowledge about RS, showing the need for further investigations to discover the mechanisms underlying its pathogenesis and to identify novel targeted agents that can individualize the treatment plan.

Update on Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: Diagnosis and Management

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are the most severe cutaneous adverse reactions that are typically drug-induced in adults. Both SJS and TEN have high morbidity and mortality rates. SJS/TEN imposes clinical challenges for physicians managing patients suffering from this condition, both because it is rare and because it is a rapidly progressing systemic disease with severe cutaneous, mucosal, and systemic manifestations. Although many cases of SJS/TEN have been reported in the literature, there is no consensus regarding diagnostic criteria or treatment. Significant progress has been made in understanding its genetic predisposition and pathogenesis. This review is intended to provide physicians with a comprehensive but practical SJS/TEN roadmap to guide diagnosis and management. We review data on pathogenesis, reported precipitating factors, presentation, diagnosis, and management SJS/TEN focusing on what is new over the last 5 years.

A case of Rowell syndrome after a herpes simplex infection and prolonged sun exposure

Rowell Syndrome is a rare entity combining erythema exudativum multiforme (EEM) and lupus erythematosus (LE). Zeitouni et al. redefined Rowell Syndrome's diagnostic criteria. Major criteria include: (1) LE (systemic, discoid or subacute cutaneous), (2) EEM-like skin lesions and (3) speckled pattern of antinuclear antibodies. Minor criteria comprise: (1) chilblains, (2) positive anti-SSA/Ro or anti-SSB/La antibodies and (3) positive rheumatoid factor. The diagnosis is achieved when all major criteria and at least one minor criterion are present. Prognosis and treatment regimens are those of EEM and LE, with reported good response to oral cortisone, azathioprine, cyclosporine, dapsone, antimalarials and methotrexate. We present a case of Rowell Syndrome in a young adult after a herpes simplex type 1 infection and unprotected sun exposure, with good response to both topical corticosteroids and calcineurin-inhibitors.

Rowell's syndrome with Condyloma acuminatum: A case report

Rowell's syndrome is an autoimmune disease characterized by lupus erythematosus, erythema multiforme skin lesions, and speckled antinuclear antibody. We report the case of a woman who presented with erythema multiforme with target-type skin lesions and vulvar vegetation who fulfilled the criteria for Rowell's syndrome and condyloma acuminatum. The simultaneous occurrence of both conditions has rarely been reported in the literature.

Rowell Syndrome in a Middle-Aged Woman: A Case Report

Rowell syndrome (RS) is characterized by the presentation of lupus erythematosus (LE) with erythema multiforme (EM)-like lesions. It is thought to display a characteristic serologic pattern consisting of a "speckled-type" antinuclear antibody (ANA), positive anti-Ro/SSA or anti-La/SSB, or positive rheumatoid factor (RF). We report the case of a patient with subacute cutaneous lupus erythematosus (SCLE) who presented with EM-like lesions responsive to oral corticosteroids.