Multi-Melanonychia Striata in a Case of Systemic Lupus Erythematosus with Concomitant Chilblain Lupus

A 27-year-old female with systemic lupus erythematosus (SLE) presented with chilblain lupus erythematosus (CHLE) and multi-melanonychia striata, a rare condition involving dark vertical striations on all nails. Her symptoms included itchy, dark lesions on the face and extremities, painful toe lesions, diffuse hair loss, and polyarthralgia. The case highlights the novelty of CHLE development in a diagnosed SLE patient. Treatment included oral prednisolone, hydroxychloroquine, topical clobetasol, and antihistamines, leading to improvement. The study emphasizes the need for high suspicion of CHLE in patients with connective tissue disorders and the potential role of hydroxychloroquine in causing melanonychia.