Department of Dermatology, Innsbruck Medical University, Innsbruck, Austria.
J Am Acad Dermatol. 2013 Mar;68(3):385-94. doi: 10.1016/j.jaad.2012.09.024. Epub 2012 Oct 12.
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.
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.
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.
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.
This was a retrospective study from a single referral center specializing in dermatologic diseases.
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.
红斑狼疮（LE）是一种系统性自身免疫性疾病。然而，有些患者只有皮肤狼疮（CLE），而另一些患者则出现内部器官受累。Ro/SS-A 抗体在光敏性 LE 变异型中经常被检测到。
调查 Ro/SS-A 抗体阳性患者中 LE 特异性和 LE 非特异性皮肤表现的患病率及其与内部器官受累的关系。
回顾了 2000 年 1 月至 2011 年 12 月期间所有 Ro/SS-A 阳性患者。仅纳入 Ro/SS-A 抗体阳性且患有 LE 的患者，并进行回顾性分析。
共有 215 例 Ro/SS-A 抗体阳性患者被诊断为 LE。年龄较大（>50 岁）的患者表现为亚急性 CLE 或慢性 CLE，且抗核抗体阴性，通常仅表现为皮肤受累。相比之下，年龄较小（<50 岁）的患者亚急性 CLE 或慢性 CLE 伴有临床和实验室标志物（疲劳、抗核抗体阳性和其他可提取核抗原）则出现内部器官受累。年轻女性患者急性 CLE 应被视为 Ro/SS-A 抗体阳性患者的一个单独亚组，因为近三分之一的患者被诊断为肾脏受累。Logistic 回归分析显示，LE 患者出现 LE 非特异性皮肤表现、关节炎、白细胞减少、抗核抗体阳性和疲劳时，会出现内部器官受累。
这是一项来自专门治疗皮肤病的单一转诊中心的回顾性研究。
LE 的特定皮肤变异型和 Ro/SS-A 检测时的年龄可预测 Ro/SS-A 抗体阳性 LE 患者内部器官受累的不同风险。
