# Toxic Epidermal Necrolysis-Like Acute Cutaneous Lupus Erythematosus Following an Upper Respiratory Infection

## TL;DR

A woman with lupus developed a rare skin condition after an upper respiratory infection, suggesting a new possible trigger for the disease.

## Contribution

This case uniquely identifies upper respiratory infections as a potential trigger for TEN-like ACLE.

## Key findings

- A 49-year-old woman with lupus developed TEN-like ACLE following an upper respiratory infection.
- URI is proposed as a novel environmental trigger for this rare skin condition.
- The case expands understanding of factors that may precipitate TEN-like ACLE.

## Abstract

Toxic epidermal necrolysis-like acute cutaneous lupus erythematosus (TEN-like ACLE) is a rare and severe form of cutaneous lupus erythematosus with an unclear etiology. We present a case of a 49-year-old woman with a past medical history of systemic lupus erythematosus, rheumatoid arthritis, and Sjögren’s overlap syndrome who developed TEN-like ACLE following a week-long upper respiratory infection (URI). While there are reported cases of TEN-like ACLE associated with excessive ultraviolet light exposure and abrupt medication discontinuation, this case uniquely highlights the novel association between URI and TEN-like ACLE, suggesting that URI may act as a previously unrecognized environmental trigger and precipitating agent for this rare condition.