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Journal of the American Academy of Dermatology
Volume 68, n° 3
pages 385-394 (mars 2013)
Doi : 10.1016/j.jaad.2012.09.024
accepted : 13 September 2012
Original Articles

Detection of Ro/SS-A antibodies in lupus erythematosus: What does it mean for the dermatologist?
 

Barbara C. Böckle, MD a, , Gunda Stanarevic, MTA a, Norbert T. Sepp, MD a, b
a Department of Dermatology, Innsbruck Medical University, Innsbruck, Austria 
b Barbara Bommer Foundation for Clinical Immundermatology, Department of Dermatology, Innsbruck Medical University, Innsbruck, Austria 

Reprint requests: Barbara C. Böckle, MD, Department of Dermatology, Innsbruck Medical University, Anichstrasse 35, 6020 Innsbruck, Austria.
Abstract
Background

Lupus erythematosus (LE) is a systemic autoimmune disease. However, some patients have only cutaneous LE (CLE), whereas others develop internal organ involvement. Ro/SS-A antibodies are frequently detected in photosensitive variants of LE.

Objective

The prevalence of LE-specific and LE-nonspecific cutaneous manifestations and their relation to internal organ involvement in Ro/SS-A antibody–positive patients were investigated.

Methods

All Ro/SS-A-positive patients between January 2000 and December 2011 were reviewed. Only patients with Ro/SS-A antibodies and LE were enrolled and retrospectively analyzed.

Results

In all, 215 Ro/SS-A antibody–positive patients were given the diagnosis of LE. Older patients (>50 years old) presenting with subacute CLE or chronic CLE and negative antinuclear antibody usually only experienced skin involvement. In contrast, internal organ involvement was observed in younger patients (<50 years old) with subacute CLE or chronic CLE presenting with the clinical and laboratory markers: fatigue, positive antinuclear antibody, and additional extractable nuclear antigen. Young female patients with acute CLE should be recognized as a separate subset of Ro/SS-A antibody–positive patients because almost a third was given the diagnosis of kidney involvement. Logistic regression analysis revealed that internal organ involvement was observed in patients with LE presenting with LE-nonspecific cutaneous manifestations, arthralgia, leukopenia, positive antinuclear antibody, and fatigue.

Limitations

This was a retrospective study from a single referral center specializing in dermatologic diseases.

Conclusion

The particular cutaneous variant of LE and age at Ro/SS-A detection predict different risks for internal organ involvement in Ro/SS-A antibody–positive patients with LE.

The full text of this article is available in PDF format.

Key words : internal organ involvement, lupus erythematosus, lupus erythematosus–nonspecific cutaneous manifestations, lupus erythematosus–specific cutaneous manifestations, Ro/SS-A antibody

Abbreviations used : ACLE, ANA, APS, ARA, CCLE, CHLE, CI, CLE, DLE, ENA, LE, LET, MLE, OR, SCLE, SLE, SS



 Funding sources: None.
 Conflicts of interest: None declared.



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