A 13-year-old girl presented to a pediatric clinic with a history of erythematous facial rash on her cheeks and the bridge of the nose. This rash had started two weeks previously, after a mosquito bite on her left cheek.
It became red and swollen first, without any sign of infection or cellulitis at or around the bite site. On physical examination, she had malar rash, oral ulcers, and history of photosensitivity.
In the site of the mosquito bite, there was a papule with a central hole. For further investigation, she was admitted to the hospital. The patient had oral ulcers, photosensitivity, malaise, weight loss, and vague musculoskeletal pain for a couple of months. Renal biopsy revealed class II lupus nephritis.
The patient was in good condition until she was bitten by a mosquito. It was hypothesized that the mosquito bite in susceptible genetically patient could have provoked some of the aforementioned mechanisms, resulting in ongoing inflammation and triggering lupus to flare-up.
It is believed that this is the first case of a mosquito bite being a trigger for lupus.
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