Systemic lupus erythematosus in patients diagnosed with treatment-resistant acne.

Background: Systemic lupus erythematosus (SLE) may involve any number of organ systems and varies greatly in the severity and type of involvement. Cutaneous manifestations of SLE are equally numerous and varied throughout the course of the disease within an individual, as well as varying between patients. Cutaneous manifestations of SLE are frequently the presenting symptoms, typically noted in the classic malar "butterfly" rash; however, other cutaneous patterns are frequently observed.

Methods: We present here two patients who presented with what was thought to be acne refractory to treatment.

Results: These patients actually were found to have a facial eruption associated with SLE as confirmed by skin biopsy.

Conclusions: The importance of investigating atypical or treatment-resistant eruptions, especially in patients experiencing other symptoms, is emphasized.