Drug-induced, Ro/SSA-positive cutaneous lupus erythematosus
| Autor: | Helen M. Santana, Carlos H. Nousari, Adrienne Rencic, Paula Bonitz, Gerardine M. Diglio, Rosemarie Watson, Grant J. Anhalt, Thomas T. Provost, Monika Srivastava, Esther Ha |
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| Rok vydání: | 2003 |
| Předmět: |
Immunodermatology
Adult Male Pathology medicine.medical_specialty Systemic disease Erythema Dermatology Autoantigens Immunopathology RNA Small Cytoplasmic Lupus Erythematosus Cutaneous Medicine Humans Aged Autoantibodies Pravastatin Retrospective Studies Skin Lupus erythematosus business.industry Anticholesteremic Agents General Medicine Hemagglutination Tests Middle Aged medicine.disease Connective tissue disease Discontinuation Ribonucleoproteins Fluorescent Antibody Technique Direct Antibodies Antinuclear Female medicine.symptom Differential diagnosis business |
| Zdroj: | Archives of dermatology. 139(1) |
| ISSN: | 0003-987X |
| Popis: | Objective To study the clinical and immunopathologic findings of drug-induced, Ro/SSA-positive cutaneous lupus erythematosus (CLE). Design Retrospective medical and laboratory record review. Setting Immunodermatology Division of Johns Hopkins Hospital (Baltimore, Md). Patients Of 120 patients found to have anti-Ro/SSA antibodies by hemagglutination and/or double immunodiffusion, 70 had clinical and immunopathologic confirmation of CLE. Fifteen of these 70 patients had a history of new drug exposure, defined as less than 6 months, associated with disease development. Results The disease-associated drugs included hydrochlorothiazide (5 patients), angiotensin-converting enzyme inhibitors (3 patients), calcium channel blockers (3 patients), interferons (2 patients), and statins (2 patients). The most common presentations were photodistributed diffuse erythema and subacute CLE-type lesions without evidence of significant systemic disease. All specimens revealed interface dermatitis and fine granular IgG deposition along the basement membrane zone and throughout the epidermis. Most patients experienced improvement or resolution of clinical lesions within 8 weeks and decrease of Ro/SSA titers within 8 months after discontinuation of drug treatment. Conclusions Antihypertensive drugs are the most commonly associated with Ro-positive CLE. Clinical and immunopathologic features of this drug-induced variant do not seem to differ from the idiopathic disease. In most cases, the disease improves or resolves on discontinuation of the offending drug treatment. It is not known if these drugs precipitate disease in patients who have subclinical disease. Drug-induced Ro/SSA-positive CLE should be included on the differential diagnosis in patients presenting with photosensitive or subacute CLE-type eruptions. |
| Databáze: | OpenAIRE |
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