LAUSR

CHLE: chilblain lupus erythematosus CTLA-4: cytotoxic T-lymphocyteeassociated antigen 4 SCLE: subacute cutaneous lupus erythematosus INTRODUCTION Chilblain lupus erythematosus (CHLE) is a rare form of chronic cutaneous lupus erythematosus characterized by purple plaques/nodules and edematous skin, mainly around the acral regions of the body. The familial form is due to a heterozygous mutation in the TREX1 gene, a widely expressed gene that encodes 39 to 59 exonuclease to remove unneeded fragments that may form during DNA replication and has also been found to be implicated in immune regulation and viral infection. The sporadic form remains with unknown etiopathogenesis. Drug-induced chilblain lupus is rare and has previously been reported predominantly in patients on tumor necrosis factor inhibitors and abatacept. We herein report a case of a man with a recent renal transplant who was started on belatacept and subsequently developed CHLE. The rash resolved with the discontinuation of the medication.