[Lupus erythematosus of the skin. An analysis of 97 patients].

In this retrospective study, the data of 97 patients with lupus erythematosus (LE) were evaluated according to clinical and laboratory criteria. 30 patients had localized chronic discoid LE (CDLE); 44 patients showed disseminated LE lesions either of the chronic discoid or the subacute cutaneous (SCLE) type; and 23 patients had systemic LE (SLE). The mean age ranged between 21 and 50 years. The male/female ratio was 1:3 in localized LE, 1:13 in disseminated LE with general symptoms, and 1:10 in SLE. Localized LE did not, as a rule, show any general symptoms. On the other hand, 14/44 patients (= 30%) with disseminated LE revealed general symptoms such as BSR elevation, arthralgia, anemia, and leukopenia. In addition, 4/44 patients (= 9%) with disseminated skin lesions showed various extracutaneous manifestations: nephritis (2), pericarditis (2), pleuritis (2), polyarthritis (1). Arthropathy was the major clinical manifestation in SLE (18/23 patients). Immunological parameters were usually negative in localized chronic discoid LE. 7/23 patients (= 30%) with disseminated LE had elevated ANA titers; 4/26 patients (= 15%) showed increased DNA binding capacity. In 57% of the patients with disseminated LE associated with general clinical symptoms, in contrast, we found elevated ANA titers; 71 of them revealed increased DNA binding capacity. Our findings suggest that disseminated LE, especially the SCLE type, may be regarded as variant of LE which tends to transition into SLE. Moreover, ANA titers may serve as a screening method; the detection of circulating DNA antibodies, however, is considered a rather specific parameter with regard to the diagnosis of systemic manifestation.