What is bullous systemic lupus erythematosus?

Bullous SLE is a rare blistering eruption that has been reported primarily in patients with established SLE. In most cases, autoantibodies are directed against type VII collagen that is found in the basement membrane zone. Vesicles and bullae may develop on inflamed or noninflamed skin. In some patients, the lesions may resemble bullous pemphigoid, and in others, epidermolysis bullosa acquisita. The diagnosis is made on the basis of clinical findings, routine histologic exam (which may show findings similar to those seen in dermatitis herpetiformis), and immunofluorescence studies including direct, indirect, and a special split-skin indirect immunofluorescence test.

Harris-Stith R, Erickson QL, Elston DM, David-Bajar K: Bullous eruption: a manifestation of lupus erythematosus, Cutis 72:31–37, 2003.