Drug-Induced Subacute Cutaneous Lupus Secondary to Sulfasalazine.

This is a rare case of a patient with rheumatoid arthritis and Sjögren's disease who developed drug-induced subacute cutaneous lupus erythematosus (DI-SCLE) while on sulfasalazine. Diagnosis was made by skin biopsy and confirmed by improvement of the rash with cessation of the offending medication. Sulfasalazine is implicated in drug-induced lupus erythematosus (DILE) but less so in DI-SCLE, although this may be in part due to underreporting from lack of biopsy confirmation and diagnostic uncertainty caused by the overlap in systemic and cutaneous lupus presentations. Drug-induced photosensitivity while on sulfasalazine and Sjögren syndrome-related antigen A (SSA) antibody positivity may have predisposed the patient to develop DI-SCLE in this case. It is always important to maintain a level of concern for drug-related adverse effects in a patient presenting with subacute cutaneous lupus erythematosus (SCLE) so that the offending drug can be promptly discontinued.