ABSTRACT
A 34-year-old woman has presented to her GP with a one-day history of high fever, lethargy and a rapidly spreading rash over the malar bones and nasal bridges. She has a five-year history of systemic lupus erythematosus (SLE) that had initially presented with inflammation and pain of the small joints of the hands, but this is now well-controlled by hydroxychloroquine. She has been monitored by a rheumatologist over the past five years and, apart from a mild anaemia, she has had no other systemic features of SLE. She does not have a history of recent foreign travel.
