Ackerman Academy of Dermatopathology, New York, New York; Department of Dermatology, Kasr Al Ainy Faculty of Medicine, Cairo University, Cairo, Egypt.
Ackerman Academy of Dermatopathology, New York, New York; Department of Dermatology, Peking University People's Hospital, Beijing, China.
J Am Acad Dermatol. 2016 Aug;75(2):404-9. doi: 10.1016/j.jaad.2016.04.057. Epub 2016 May 28.
Diagnosis of lupus erythematosus (LE) in direct immunofluorescence testing is based on the finding of positive immunofluorescence at the dermoepidermal junction (DEJ).
We sought to evaluate the sensitivity of IgM deposition at the DEJ and adnexal structures in the diagnosis of lupus erythematosus.
We conducted a retrospective study of 100 previously diagnosed cases of lupus erythematosus and 158 cases of other immune-mediated dermatosis. Deposition of IgG, IgM, IgA, and C3 at the DEJ, follicular units, and sweat glands were recorded. Presence or absence of adnexal structures was documented. The immunoreactant deposition was documented as linear, coarse granular, or stippled.
The most frequently deposited immunoreactant in lupus erythematosus cases was IgM along the DEJ and stromal-epithelial junction of hair follicles and sweat glands. IgM deposition along the stromal-epithelial junction of hair follicles and sweat glands was strongly associated with a diagnosis of lupus erythematosus compared with other immune-mediated diseases collectively (P value < .001). The pattern of IgM in lupus and dermatomyositis is granular, in contrast to the linear deposition in the other disorders evaluated.
This was a retrospective study of archived material.
Granular IgM deposition at the stromal-epithelial junction of cutaneous adnexal structures suggests a diagnosis of lupus erythematosus or dermatomyositis.
红斑狼疮（LE）的直接免疫荧光检测诊断基于在表皮-真皮交界处（DEJ）发现阳性免疫荧光。
我们旨在评估 DEJ 和附属结构中 IgM 沉积在红斑狼疮诊断中的敏感性。
我们对 100 例先前诊断的红斑狼疮病例和 158 例其他免疫介导性皮肤病病例进行了回顾性研究。记录 IgG、IgM、IgA 和 C3 在 DEJ、毛囊单位和汗腺中的沉积。记录附属结构的存在与否。免疫反应物沉积被记录为线性、粗颗粒状或点状。
在红斑狼疮病例中最常沉积的免疫反应物是 IgM，沿着 DEJ 和毛囊和汗腺的基质-上皮交界处。与其他免疫介导性疾病（ collectively ）相比，IgM 沿着毛囊和汗腺的基质-上皮交界处沉积与红斑狼疮的诊断强烈相关（P 值<.001）。红斑狼疮和皮肌炎中 IgM 的模式是颗粒状的，与评估的其他疾病中的线性沉积形成对比。
这是对存档材料的回顾性研究。
皮肤附属结构的基质-上皮交界处的颗粒状 IgM 沉积提示红斑狼疮或皮肌炎的诊断。
