Abstract: We report a case of systemic lupus erythematosus with cutaneous vasculitis as the initial manifestation. A 51-year-old female presented with ecchymosis on both lower limbs and buttocks with itching and pain for 1 week. The histopathological examination of the skin lesions revealed dermal collagen degeneration, fibrinoid necrosis, and vasculitis changes. Multiple antibodies, such as the anti-dsDNA antibody, anti-SSA antibody, and antinuclear antibody, were positive. The patient was diagnosed with systemic lupus erythematosus, with a SLEDAI score of 12. After two weeks of glucocorticoid treatment, the skin lesions improved significantly. After being discharged from the hospital, the patient stopped taking the medication by herself, and the condition deteriorated, leading to multi-system damage involving the heart, lungs, liver, kidneys, and blood system. Eventually, the patient died due to critical illness.

Key words: lupus erythematosus, systematic, vasculitis