While the transient appearance of vesicles in the skin of patients with systemic lupus erythematosus has been amply documented,1-6 little attention has been called to the occurrence of giant bullae as a manifestation of the disease. The classical lesion of systemic lupus in the skin is macular, erythematous, and only rarely leads to vesicle, bleb formation, or crusting.7 Indeed, while the mucous membrane lesions are felt perhaps to originate in vesicles,6 the skin ulcerations occasionally seen in patients with systemic lupus have rarely been attributed to such primary vesiculation.2 The occurrence of bullous lesions is noted in most large series of observations,2,4,6 but such lesions have not been reported to dominate the cutaneous manifestations in any given case. Recently we have seen 2 patients, in whose clinical picture giant bullae leading to ulceration and scarification were the predominant skin lesions.
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