Paraneoplastic systemic lupus erythematosus in association with oat cell tumour of the lung

A 63-year-old man presented in the emergency department with general malaise, asthenia, an erythematosquamous rash on face and forearms and severe hyponatremia. The rash appeared after working in his garden on a sunny afternoon without sunscreen protection (Figure 1A/B/C). Furosemide was stopped and once daily mometason furoate cream was prescribed. Hyponatremia was corrected by IV hypertonic fluids. Five days later, the rash spread to the upper legs, chest and back. Histopathology revealed damage of the basal layer with necrotic keratinocytes and dermal perivascular and adnexal infiltrates (Figure 2).

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