“Borrelia-associated early-onset morphea”: A particular type of scleroderma in childhood and adolescence with high titer antinuclear antibodies? : Results of a cohort analysis and presentation of three cases - 08/08/11
, Zsuzsanna Kutasi, MD b, Peter Weisenseel, MD a, László Pótó, PhD c, Zita Battyáni, MD, PhD b, Thomas Ruzicka, MD a
Reprint requests: Joerg C. Prinz, MD, Department of Dermatology, University of Munich, Frauenlobstr. 9-11, 80337 Munich, Germany.Abstract |
Background |
Morphea is an inflammatory autoimmune skin sclerosis of unknown etiology. A causative role of Borrelia burgdorferi infection has been controversially discussed, but no conclusive solution has yet been achieved.
Objective |
Intrigued by 3 young patients with severe Borrelia-associated morphea and high-titer antinuclear antibodies, we retrospectively examined the relationship between Borrelia exposure, serologic autoimmune phenomena and age at disease onset in morphea patients.
Methods |
In 90 morphea patients the presence of Borrelia-specific serum antibodies was correlated to the age at disease onset and the presence and titers of antinuclear antibodies. Patients with active Borrelia infection or high-titer antinuclear antibodies due to systemic sclerosis or lupus erythematosus served as controls.
Results |
We observed a statistically highly significant association between morphea, serologic evidence of Borrelia infection, and high-titer antinuclear antibodies when disease onset was in childhood or adolescence.
Limitations |
Because pathogenic Borrelia species may vary in different geographic regions the relevance of Borrelia infection in morphea induction may show regional variations.
Conclusion |
B burgdorferi infection may be relevant for the induction of a distinct autoimmune type of scleroderma; it may be called “Borrelia-associated early onset morphea” and is characterized by the combination of disease onset at younger age, infection with B burgdorferi, and evident autoimmune phenomena as reflected by high-titer antinuclear antibodies. As exemplified by the case reports, it may take a particularly severe course and require treatment of both infection and skin inflammation
Le texte complet de cet article est disponible en PDF.Abbreviations used : ANA, ELISA, ROC
Plan
| Supported by the Deutsche Forschungsgemeinschaft, SFB 571. Dr Kutasi had received a Leonardo Mobility Program scholarship of the European Union. |
|
| Conflicts of interest: None declared. |
Vol 60 - N° 2
P. 248-255 - février 2009 Retour au numéro
Article précédent
- Spitz nevi: In vivo confocal microscopic features, dermatoscopic aspects, histopathologic correlates, and diagnostic significance
- Giovanni Pellacani, Caterina Longo, Gerardo Ferrara, Anna Maria Cesinaro, Sara Bassoli, Pascale Guitera, Scott W. Menzies, Stefania Seidenari
- The role of helper and regulatory T cells in the pathogenesis of vitiligo
- Pinar Y. Basak, Ali K. Adiloglu, Ali Murat Ceyhan, Tekin Tas, Vahide B. Akkaya
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?