PMID- 9520021
OWN - NLM
STAT- MEDLINE
DCOM- 19980408
LR  - 20190709
IS  - 0190-9622 (Print)
IS  - 0190-9622 (Linking)
VI  - 38
IP  - 3
DP  - 1998 Mar
TI  - Subacute cutaneous lupus erythematosus versus systemic lupus erythematosus: 
      diagnostic criteria and therapeutic implications.
PG  - 405-12
AB  - BACKGROUND: The nosologic position of subacute cutaneous lupus erythematosus 
      (SCLE) is controversial. More than four American Rheumatism Association (ARA) 
      criteria for systemic lupus erythematosus (SLE) are found in a proportion of 
      patients diagnosed as having SCLE; thus such cases could be classified as SLE. 
      OBJECTIVE: Our purpose was to determine whether ARA criteria for SLE are helpful 
      in differentiating SCLE from SLE and whether cutaneous and visceral changes, 
      immunologic findings, and photosensitivity provide a basis for diagnosis of SCLE. 
      METHODS: A cohort of 143 patients (79 with SCLE, 58 with SLE, and six with 
      overlapping features of SCLE and SLE) was studied clinically, histologically, and 
      immunologically as well as by phototesting. The patients were observed for up to 
      10 years, and the course of the disease and response to therapy were evaluated in 
      each group. RESULTS: SCLE differed from SLE by cutaneous changes, significantly 
      less frequent kidney involvement, serositis and arthritis, and the rare presence 
      of double-stranded DNA, U1RNP, and Sm antibodies characteristic of SLE. Ro(SS-A) 
      and La(SS-B) antibodies were detected with similar frequency, and 
      photosensitivity was not related to the presence of Ro antibody. In contrast, 
      photoreproduction (appearance of LE lesion in irradiated area) was significantly 
      more frequent in patients with SCLE. The course of SCLE in older patients was 
      less severe than in younger patients, and aggressive therapy was usually not 
      required. CONCLUSION: Patients with SCLE (although the majority fulfill more than 
      four ARA criteria for SLE) show significant differences from those with SLE in 
      terms of cutaneous and visceral involvement, immunologic findings, 
      photosensitivity, course of the disease, and the requirement for therapy. 
      Therefore SCLE should be recognized as a separate subset. However, cases of 
      overlapping SLE and SCLE suggest a close relation.
FAU - Chlebus, E
AU  - Chlebus E
AD  - Department of Dermatology, Warsaw School of Medicine, Warszawa, Poland.
FAU - Wolska, H
AU  - Wolska H
FAU - Blaszczyk, M
AU  - Blaszczyk M
FAU - Jablonska, S
AU  - Jablonska S
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Am Acad Dermatol
JT  - Journal of the American Academy of Dermatology
JID - 7907132
RN  - 0 (Antibodies, Antinuclear)
RN  - 0 (Ribonucleoproteins)
RN  - 0 (SS-A antibodies)
RN  - 0 (SS-B antibodies)
RN  - 9007-49-2 (DNA)
SB  - IM
CIN - J Am Acad Dermatol. 1999 Jan;40(1):129-31. PMID: 9922032
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Antibodies, Antinuclear/analysis
MH  - Arthralgia/complications
MH  - DNA/analysis
MH  - Diagnosis, Differential
MH  - Female
MH  - Humans
MH  - Kidney/pathology
MH  - Lupus Erythematosus, Cutaneous/*diagnosis/drug therapy/immunology/pathology
MH  - Lupus Erythematosus, Systemic/*diagnosis/drug therapy/immunology/pathology
MH  - Male
MH  - Middle Aged
MH  - Photosensitivity Disorders/complications
MH  - Ribonucleoproteins/immunology
MH  - Serositis/complications
MH  - Skin/pathology
EDAT- 1998/03/31 00:00
MHDA- 1998/03/31 00:01
CRDT- 1998/03/31 00:00
PHST- 1998/03/31 00:00 [pubmed]
PHST- 1998/03/31 00:01 [medline]
PHST- 1998/03/31 00:00 [entrez]
AID - S0190-9622(98)70497-9 [pii]
AID - 10.1016/s0190-9622(98)70497-9 [doi]
PST - ppublish
SO  - J Am Acad Dermatol. 1998 Mar;38(3):405-12. doi: 10.1016/s0190-9622(98)70497-9.