[Significance of speckled staining of epidermal nuclei in direct immunofluorescence. 10 cases (author's transl)].

This study involved 10 patients having, in direct immunofluorescence, with covered healthy skin, a speckled IgG (+/-IgM) staining of the epidermal nuclei. The chief clinical signs seen and their respective percentages were: Raynaud's syndrome (80%), arthralgia (80%), diffuse or localised alopoecia (60%), muscular disease (40%), swollen fingers (40%), sclerodactylie (20%), cutaneous sclerosis extending beyond the extremities (30%), cutaneous signs of lupus erythematosus (30%), renal involvement (10%). In nine cases out of ten there were circulating anti-ENA antibodies at high levels, divided into anti-RNP antibodies (7/10), anti-Sm antibodies (1/10) and anti-RNP and anti-Sm antibodies (1/10). Diagnoses were divided into: lupus erythematosus (3/10), systemic scleroderma (3/10), Sharp's mixed connective tissue disease (MCTD) (3/10) and non-classified connective tissue disease (1/10). The combination of speckled staining of epidermal nuclei and circulating anti-ENA antibodies cannot be considered to be specific of any particular type of connective tissue disease and the prognosis of the disease does not appear to differ from that of the usual prognosis of connective tissue disease with anti-ENA antibodies.