Gilliam J N, Prystowsky S D
Arch Dermatol. 1977 May;113(5):583-7.
Fifteen patients with epidermal nuclear staining on direct immunofluorescence of normal skin and high titer serum antibody to ribonuclease-sensitive extractable nuclear antigen (ENA) had diffuse nonscarring and focal alopecia, abnormal pigmentation, swollen hands with sclerodactyly, and chronic cutaneous lupus erythematosus (LE) as the most common dermatologic features. Direct immunofluorescence of normal, unexposed skin revealed a particulate ('speckled') epidermal nuclear staining pattern in all 15 patients and subepidermal immunoglobulin deposits in 5. Ribonucleoprotein antibodies in high titer are associated with this characteristic type of epidermal nuclear staining. These findings provide easily detectable markers for a less aggressive subset of LE characterized by distinctive clinical and laboratory features consistent with mixed connective tissue disease.
15例正常皮肤直接免疫荧光显示表皮核染色且抗核糖核酸酶敏感的可提取核抗原（ENA）血清抗体滴度高的患者，最常见的皮肤表现为弥漫性非瘢痕性和局灶性脱发、色素沉着异常、手部肿胀伴指硬皮病以及慢性皮肤型红斑狼疮（LE）。对正常未暴露皮肤进行直接免疫荧光检查发现，所有15例患者均有颗粒状（“斑点状”）表皮核染色模式，5例有表皮下免疫球蛋白沉积。高滴度核糖核蛋白抗体与这种特征性的表皮核染色类型相关。这些发现为一种侵袭性较小的LE亚组提供了易于检测的标志物，其具有与混合性结缔组织病一致的独特临床和实验室特征。
