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Systemic lupus erythematosus: clinical expression and anti-Ro/SS—A response in patients with and without lesions of subacute cutaneous lupus erythematosus

Service of Rheumatology and Experimental Medicine Unit, 'Gregorio Marañón' Hospital, Universidad Complutense of Madrid, Spain

I. Monteagudo

Service of Rheumatology and Experimental Medicine Unit, 'Gregorio Marañón' Hospital, Universidad Complutense of Madrid, Spain

CM González

Service of Rheumatology and Experimental Medicine Unit, 'Gregorio Marañón' Hospital, Universidad Complutense of Madrid, Spain

R. Grau

Service of Rheumatology and Experimental Medicine Unit, 'Gregorio Marañón' Hospital, Universidad Complutense of Madrid, Spain

L. Carreño

Service of Rheumatology and Experimental Medicine Unit, 'Gregorio Marañón' Hospital, Universidad Complutense of Madrid, Spain

Patients with subacute cutaneous lupus erythematosus (SCLE) have recurrent annular and/or psoriasiphorm skin lesions, with or without systemic disease.

Objective: To analyse the clinical expression and the Ro/SS-A response associated with SCLE in patients with systemic lupus erythematosus (SLE).

Methods: 128 consecutive patients with SLE were studied. Anti-Ro/SS-A antibodies were detected by ELISA, (anti-60 kD Ro/SSA antibodies), immunoblotting (anti-60 kD and anti-52 kD Ro/SS-A antibodies) and counterimmunoelectrophoresis (CIE).

Results: Seventeen patients (13.2%) showed SCLE lesions. Photosensitivity was more frequent in patients with SCLE (82%) than in patients without these cutaneous lesions (45%) (OR: 5.6). Arthritis (OR: 6.3), Raynaud's phenomenon (OR: 4.9), pleuritis (OR: 7.6), central nervous system disorder (OR: 6.4), renal disease (OR: 6.3), anemia (OR: 7.9), hypocomplementemia (OR: 6.1) and anti-dsDNA antibodies (OR: 12.7) were significantly more frequent in patients without SCLE. Anti-Ro/SS-A antibodies were detected in 15 (88.2%) patients with SCLE and 62 (55.8%) patients without SCLE by ELISA, in 10 (58.8%) and 34 (30.6%) patients by immunoblotting, and in 13 (76.4%) and 34 (30.6%) by CIE, respectively. Anti-60 kD-Ro/SS-A and anti-La antibodies, but not anti-52 kD-Ro/SS-A, were significantly more frequent in patients with SCLE than in patients without SCLE.

Conclusions: The presence of SCLE lesions in patients with SLE is associated with a more favourable prognosis. The major anti-Ro/SS-A response is directed against the native 60 kD Ro/SSA protein.

Key Words: systemic lupus erythematosus • subacute cutaneous lupus erythematosus • anti-snRNP antibodies • anti-Ro/SS-A antibodies

Lupus, Vol. 6, No. 1, 32-39 (1997)
DOI: 10.1177/096120339700600105


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