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Chilblain lupus erythematosus is associated with antibodies to SSA/Ro

Clinical Immunology Unit; Spedali Civili, Brescia, Italy; Servizio di Immunologia Clinica-Spedali Civili, P.le Spedali Civili, 1; 25100-Brescia ITALY; doff{at}numerica.it

P Calzavara-Pinton

Division of Dermatology; Spedali Civili, Brescia, Italy

M Quinzanini

I Cavazzana

L Bettoni

Clinical Immunology Unit; Spedali Civili, Brescia, Italy

C Zane

F Facchetti

Department of Pathology, Spedali Civili, Brescia, Italy

P Airò

Clinical Immunology Unit; Spedali Civili, Brescia, Italy

D P McCauliffe

Department of Dermatology, University of North Carolina, Chapel Hill, USA

R Cattaneo

Clinical Immunology Unit; Spedali Civili, Brescia, Italy

Chilblain lupus erythematosus (CL) of Hutchinson is a subtype of lupus erythematosus (LE) characterized by erythematous lesions induced by cold, damp climates. A number of patients affected by CL eventually develop features of systemic lupus erythematosus (SLE).We report here 9 patients with chilblain cutaneous lesions, 6 of them were affected by SLE and 2 by SCLE. The onset of CL preceded the diagnosis of LE, from 1 to 10 years in 3 cases, it was concurrent in one case and was subsequent in the remaining 4 cases. Raynaud's phenomenon and photosensitivity were other prominent clinical features in patients with CL. Nailfold capillaroscopy revealed pathological changes in every patient examined. ANA and anti-SSA/Ro antibodies were detected in all nine patients. Anti-SSB/La were detected in 2 cases, anti-Sm in one case, and anti Sm and anti-RNP in a one case. Antibodies to dsDNA and complement consumption were found in the six patients with SLE. The fine specificity of anti-SSA/Ro was determined by immunoblotting: anti-60kD and anti-52 kD were detected in three sera, anti-60kD alone in 5 sera, while one serum did not blot.

In conclusion, the present study suggests that chilblain LE is associated with SSA/Ro autoantibodies, as is SCLE, hypergammaglobulinemic purpura and neonatal lupus erythematosus.

Key Words: chilblain lupus • antinuclear antibodies • anti-SSa/Ro antibodies • nailfold capillaroscopy

Lupus, Vol. 8, No. 3, 215-219 (1999)
DOI: 10.1191/096120399678847632


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