Petzelbauer P, Binder M, Nikolakis P, Ortel B, Hönigsmann H
Department of Dermatology I, University of Vienna Medical School, Austria.
J Am Acad Dermatol. 1992 Jan;26(1):68-74. doi: 10.1016/0190-9622(92)70009-5.
Initial lesions seen in some cases of lupus erythematosus may simulate the clinical features of polymorphous light eruption.
To evaluate the significance of antinuclear antibody screening in patients with polymorphous light eruption or to find better methods to define patients at risk to have lupus erythematosus, we analyzed the data of 198 patients with polymorphous light eruption.
History, type, and persistence of skin lesions were reviewed, and serologic variables, the minimal erythema dose, and the ultraviolet action spectrum for inducing skin lesions were determined.
The morphologic features of skin lesions and results of phototesting were consistent with previously published characteristics of patients with polymorphous light eruption. Twenty-eight (14%) had high titers of antinuclear antibody (greater than or equal to 1:80). We found a highly significant correlation between severe sun sensitivity and the presence of high antinuclear antibody titers. Of these patients with severe sun sensitivity and high titers of antinuclear antibody, in three the diagnosis of systemic lupus erythematosus could be established according to American Rheumatism Association criteria.
These results suggest that a combination of severe sun sensitivity and high titers of antinuclear antibody may characterize a subset of sun-sensitive patients with some features of lupus erythematosus.
在一些红斑狼疮病例中最初出现的皮损可能类似多形性日光疹的临床特征。
为评估抗核抗体筛查在多形性日光疹患者中的意义，或寻找更好的方法来确定有患红斑狼疮风险的患者，我们分析了198例多形性日光疹患者的数据。
回顾皮损的病史、类型和持续时间，并测定血清学变量、最小红斑量以及诱发皮肤损害的紫外线作用光谱。
皮肤损害的形态学特征和光试验结果与先前发表的多形性日光疹患者的特征一致。28例（14%）抗核抗体效价高（大于或等于1:80）。我们发现严重的日光敏感性与抗核抗体高滴度之间存在高度显著的相关性。在这些严重日光敏感且抗核抗体高滴度的患者中，根据美国风湿病学会标准，有3例可确诊为系统性红斑狼疮。
这些结果表明，严重的日光敏感性和抗核抗体高滴度可能是具有某些红斑狼疮特征的日光敏感患者亚组的特征。
