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

## TL;DR

This paper presents a case of Rowell Syndrome in a 43-year-old man following a herpes infection and sun exposure, highlighting its rare combination of skin conditions and successful treatment.

## Contribution

The paper contributes a new clinical case of Rowell Syndrome triggered by herpes simplex and sun exposure, with a successful treatment response to topical corticosteroids and calcineurin inhibitors.

## Key findings

- Rowell Syndrome can occur after herpes simplex type 1 infection and sun exposure.
- The patient showed good response to topical corticosteroids and calcineurin inhibitors.
- The case highlights the importance of recognizing Rowell Syndrome's combination of EEM and SCLE.

## Abstract

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.

A 43‐year‐old male with previous history of alopecia areata presented with an erythema exudativum multiforme (EEM) after a herpes simplex type 1 infection, as well as subacute cutaneous lupus erythematosus (SCLE) lesions after severe sun exposure during a trip to the Dominican Republic. The combination of EEM and SCLE is a rare condition known as Rowell Syndrome. Our patient responded well to topical corticosteroids and calcineurin inhibitors. the image chosen for the graphical abstarct is not the most representative. If an image needs to be added here, I would advise to use one of the arms or back.