PMID- 1512459
OWN - NLM
STAT- MEDLINE
DCOM- 19920929
LR  - 20190723
IS  - 0022-202X (Print)
IS  - 0022-202X (Linking)
VI  - 99
IP  - 3
DP  - 1992 Sep
TI  - Clinical, histologic, and immunofluorescent distinctions between subacute 
      cutaneous lupus erythematosus and discoid lupus erythematosus.
PG  - 251-7
AB  - Subacute cutaneous lupus erythematosus (SCLE) was originally described and 
      distinguished from discoid lupus erythematosus (DLE) on the basis of clinical 
      examination of the skin, but subsequent reports have questioned the concept of 
      SCLE as a marker of a unique subset of LE patients. We classified 27 lupus 
      patients, on the basis of cutaneous exam, as having discoid lupus skin lesions, 
      subacute cutaneous skin lesions, or systemic lupus erythematosus (SLE) without 
      DLE or SCLE lesions. Clinical features most characteristic of SCLE rather than 
      DLE were superficial, non-indurated, non-scarring lesions, and photosensitivity, 
      with lack of induration being the single most helpful finding. Histologic 
      examination of lesional skin showed a relatively sparse, superficial infiltrate 
      in SCLE and a denser, deeper infiltrate in DLE. A distinctive pattern of staining 
      with direct immunofluorescence, particulate epidermal IgG deposition, was found 
      in seven of seven SCLE patients (all anti-Ro/SSA positive) and none of the other 
      patients. This distinctive pattern can be reproduced experimentally when 
      anti-Ro/SSA autoantibodies are infused into human skin-grafted mice. Particulate 
      dermal-epidermal junctional staining was the pattern seen in the patients who did 
      not have SCLE. Clinically defining SCLE as a superficial inflammatory form of 
      cutaneous lupus (i.e., considering lesions to be DLE if they are indurated) 
      results in a meaningful segregation of SCLE and DLE patient groups. The epidermal 
      IgG deposits unique to SCLE provide independent evidence that the clinical 
      findings that were used to identify the patient groups actually identify 
      distinctive cutaneous lupus subsets. The observation that antibodies are present 
      in a different location in the skin in SCLE than in DLE indicates that SCLE and 
      DLE are likely to have different pathomechanisms.
FAU - David-Bajar, K M
AU  - David-Bajar KM
AD  - Department of Dermatology, University of Colorado School of Medicine, Denver.
FAU - Bennion, S D
AU  - Bennion SD
FAU - DeSpain, J D
AU  - DeSpain JD
FAU - Golitz, L E
AU  - Golitz LE
FAU - Lee, L A
AU  - Lee LA
LA  - eng
GR  - AR01487/AR/NIAMS NIH HHS/United States
GR  - AR07411/AR/NIAMS NIH HHS/United States
PT  - Journal Article
PT  - Research Support, U.S. Gov't, P.H.S.
PL  - United States
TA  - J Invest Dermatol
JT  - The Journal of investigative dermatology
JID - 0426720
RN  - 0 (Antibodies, Antinuclear)
RN  - 0 (Immunoglobulins)
RN  - 0 (SS-A antibodies)
RN  - 80295-43-8 (Complement C3b)
SB  - IM
MH  - Antibodies, Antinuclear/analysis
MH  - Complement C3b/analysis
MH  - Diagnosis, Differential
MH  - Fluorescent Antibody Technique
MH  - Humans
MH  - Immunoglobulins/analysis
MH  - Lupus Erythematosus, Cutaneous/immunology/*pathology
MH  - Lupus Erythematosus, Discoid/immunology/*pathology
EDAT- 1992/09/01 00:00
MHDA- 1992/09/01 00:01
CRDT- 1992/09/01 00:00
PHST- 1992/09/01 00:00 [pubmed]
PHST- 1992/09/01 00:01 [medline]
PHST- 1992/09/01 00:00 [entrez]
AID - S0022-202X(92)90463-E [pii]
AID - 10.1111/1523-1747.ep12616582 [doi]
PST - ppublish
SO  - J Invest Dermatol. 1992 Sep;99(3):251-7. doi: 10.1111/1523-1747.ep12616582.