Weinstein C, Miller M H, Axtens R, Littlejohn G O, Dorevitch A P, Buchanan R
Prince Henry's Hospital, Melbourne, Vic, Australia.
Aust N Z J Med. 1987 Oct;17(5):501-6. doi: 10.1111/j.1445-5994.1987.tb00108.x.
Mucocutaneous manifestations occur frequently in systemic lupus erythematosus (SLE). Common non-lupus dermatoses may be confused with lupus rashes, with important clinical consequences. A study of 84 consecutive patients with SLE was performed to determine the comparative frequency of lupus and non-lupus mucocutaneous abnormalities, the comparative sensitivity of routine histology and immunofluorescence in the diagnosis of lupus rashes, and the association of skin manifestations with other clinical and serological features. Thirty-five patients had dermatoses attributable to SLE (mean 3.7 per patient) and 58 had dermatoses which were not directly attributable to SLE (mean 2.1 per patient), highlighting the need for accurate diagnosis of skin rashes in SLE patients. Routine histology confirmed the clinical diagnosis of typical cutaneous lupus in 100% of malar lupus rashes and in approximately 90% of subacute cutaneous and discoid lupus rashes. Direct immunofluorescence of the affected skin provided supportive evidence of cutaneous lupus in 60% of malar lupus rashes and approximately 50% of subacute cutaneous and discoid lupus rashes. This reaffirmed the poor sensitivity of immunofluorescence, compared with routine histology, in the diagnosis of lupus rashes. The association of subacute cutaneous lupus with anti-Ro antibodies was confirmed.
黏膜皮肤表现频繁出现在系统性红斑狼疮（SLE）中。常见的非狼疮性皮肤病可能与狼疮皮疹相混淆，从而产生重要的临床后果。对84例连续的SLE患者进行了一项研究，以确定狼疮性和非狼疮性黏膜皮肤异常的相对频率、常规组织学和免疫荧光在狼疮皮疹诊断中的相对敏感性，以及皮肤表现与其他临床和血清学特征的关联。35例患者有归因于SLE的皮肤病（平均每位患者3.7种），58例患者有并非直接归因于SLE的皮肤病（平均每位患者2.1种），这突出了准确诊断SLE患者皮疹的必要性。常规组织学在100%的颧部狼疮皮疹以及约90%的亚急性皮肤型和盘状狼疮皮疹中证实了典型皮肤狼疮的临床诊断。对受累皮肤进行直接免疫荧光检查，在60%的颧部狼疮皮疹以及约50%的亚急性皮肤型和盘状狼疮皮疹中提供了皮肤狼疮的支持性证据。这再次证实了与常规组织学相比，免疫荧光在狼疮皮疹诊断中的敏感性较差。亚急性皮肤型狼疮与抗Ro抗体的关联得到了证实。
