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Autoantibody profile and clinical patterns in 619 Italian patients with cutaneous lupus erythematosus
Author(s) -
Verdelli A.,
Coi A.,
Marzano A.V.,
Antiga E.,
Cozzani E.,
Quaglino P.,
La Placa M.,
Benucci M.,
De Simone C.,
Papini M.,
Parodi A.,
Bianchi F.,
Caproni M.
Publication year - 2019
Publication title -
journal of the european academy of dermatology and venereology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.655
H-Index - 107
eISSN - 1468-3083
pISSN - 0926-9959
DOI - 10.1111/jdv.15147
Subject(s) - autoantibody , medicine , extractable nuclear antigens , antibody , immunology , anti nuclear antibody , systemic lupus erythematosus , disease
Background Anti‐nuclear antibodies ( ANA ), anti‐extractable nuclear antigens ( ENA ) and anti‐ds DNA antibodies are often associated with cutaneous lupus erythematosus ( CLE ), with variable frequency depending on skin subtype. However, specific data based on large case‐series on the pathogenetic, diagnostic and prognostic meaning of such autoantibodies are still lacking. Objective To characterize the correlations between CLE subtypes as well as LE ‐non‐specific skin lesions and their autoantibody pattern. Methods Epidemiological, clinical and immunopathological data of 619 Italian patients with CLE and LE ‐non‐specific skin lesions were analysed. Differences in age, sex, clinical features and autoantibody profile were evaluated in each LE subgroup. Results Anti‐nuclear antibodies ( P < 0.0001), anti‐ds DNA ( P < 0.0001), ENA ( P = 0.001), anti‐Sm ( P = 0.001), anti‐ RNP ( P = 0.004) and anti‐histone ( P = 0.005) antibodies were associated with SLE . A strong association between ANA ( P < 0.0001) and anti‐ds DNA ( P < 0.0001) and female gender was also found: positive ANA and positive anti‐ds DNA had a higher prevalence among females. Chronic CLE resulted to be negatively associated with ENA ( OR = 0.51, P < 0.0001), anti‐Ro/ SSA ( OR = 0.49, P < 0.0001) and anti‐ds DNA ( OR = 0.37, P < 0.0001). Intermittent CLE resulted to be negatively associated with ENA ( OR = 0.50, P = 0.007) and ANA ( OR = 0.61, P = 0.025). Subacute CLE resulted to be associated with ENA ( OR = 5.19, P < 0.0001), anti‐Ro/ SSA ( OR = 3.83, P < 0.0001), anti‐Smith ( OR = 2.95, P = 0.004) and anti‐ RNP ( OR = 3.18, P = 0.007). Acute CLE resulted to be strongly associated with anti‐ds DNA ( OR = 6.0, P < 0.0001) and ANA ( OR = 18.1, P < 0.0001). LE ‐non‐specific skin lesions resulted to be significantly associated with systemic involvement. Livedo reticularis was significantly associated with ENA ( P = 0.007) and anti‐Ro/ SSA ( P = 0.036). Palpable purpura and periungual telangiectasia were significantly associated with ANA . Conclusion According to our findings, some well‐known associations between CLE subtypes and autoantibody profile were confirmed; moreover, specific association between autoantibodies and LE ‐non‐specific skin lesions was highlighted. A strict association between anti‐ ENA and anti‐Ro/ SSA antibodies and livedo reticularis, ANA and palpable purpura, and ANA and periungual telangiectasia was evidenced.