Doria A, Biasinutto C, Ghirardello A, Sartori E, Rondinone R, Piccoli A, Veller Fornasa C, Gambari P F
Division of Rheumatology, University of Padova, Italy.
Lupus. 1996 Aug;5(4):263-8. doi: 10.1177/096120339600500404.
The aim of our study was to evaluate the prevalence of photosensitivity in SLE as defined by either clinical or laboratory assessment, the concordance of findings obtained by two methods, and the relationship between photosensitivity and clinical and immunological parameters.
Forty-four SLE patients and 31 healthy subjects were included. Patients and controls underwent a standard questionnaire testing and the minimal erythemal dose (MED) measurement performed by Dermalight-Blue Point. The standard questionnaire was designed in order to meet, as near as possible, the definition of photosensitivity included in the ARA/ACR criteria for classification of SLE.
The prevalence of photosensitivity was (patients vs controls): 57% vs 45% according to questionnaire; 79.5% vs 51.6% (P = 0.02) according to MED. The agreement between questionnaire and phototest was absent in SLE (kappa 0.01) and poor in controls (kappa 0.36). Discoid rash was significantly associated with questionnaire positive (P = 0.01) and renal involvement with questionnaire negative results (P = 0.02), serositis with MED abnormality (P = 0.03), malar rash and anti-Sm antibody with MED normal values (P = 0.03 and P = 0.01), respectively). Moreover, by multivariate analysis, malar rash and anti-Sm antibody significantly predicted MED-defined photosensitivity, with probability ranging from 42% (presence of both) to 92% (lack of both).
Photosensitivity is frequently observed in SLE patients as well as in healthy subjects. Its prevalence is significantly higher in SLE than in controls only when it is detected using the laboratory method. However, due to the difficulty in objectively defining such manifestation, the disagreement between questionnaire and MED results was high and its clinical meaning appears ambiguous. Thus, the use of photosensitivity as a classification criterion for SLE remains questionable, at least when it is assessed according to the ARA/ACR definition.
我们研究的目的是评估根据临床或实验室评估所定义的系统性红斑狼疮（SLE）中光敏性的患病率、两种方法所得结果的一致性，以及光敏性与临床和免疫学参数之间的关系。
纳入44例SLE患者和31名健康受试者。患者和对照者接受标准问卷调查，并通过Dermalight - 蓝点法测量最小红斑量（MED）。设计标准问卷是为了尽可能符合美国风湿病学会（ARA）/美国风湿病学会（ACR）SLE分类标准中包含的光敏性定义。
光敏性的患病率（患者与对照者）：根据问卷为57%对45%；根据MED为79.5%对51.6%（P = 0.02）。SLE患者中问卷与光试验之间缺乏一致性（kappa值为0.01），对照者中一致性较差（kappa值为0.36）。盘状红斑与问卷阳性显著相关（P = 0.01），肾脏受累与问卷阴性结果相关（P = 0.02），浆膜炎与MED异常相关（P = 0.03），颧部红斑和抗Sm抗体分别与MED正常数值相关（P = 0.03和P = 0.01）。此外，通过多变量分析，颧部红斑和抗Sm抗体显著预测MED定义的光敏性，概率范围从42%（两者均存在）到92%（两者均不存在）。
SLE患者以及健康受试者中经常观察到光敏性。仅当使用实验室方法检测时，其在SLE中的患病率才显著高于对照者。然而，由于客观定义这种表现存在困难，问卷和MED结果之间的不一致性很高，其临床意义似乎不明确。因此，至少根据ARA/ACR定义进行评估时，将光敏性用作SLE的分类标准仍存在疑问。
