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Are there distinct clinical and pathological features distinguishing idiopathic from drug-induced subacute cutaneous lupus erythematosus? A European retrospective multicenter study.
Journal of the American Academy of Dermatology ( IF 12.8 ) Pub Date : 2019-02-11 , DOI: 10.1016/j.jaad.2019.02.009
Federica Guicciardi 1 , Laura Atzori 2 , Angelo Valerio Marzano 3 , Simona Tavecchio 3 , Giampiero Girolomoni 4 , Chiara Colato 5 , Axel Patrice Villani 6 , Jean Kanitakis 7 , Christina Mitteldorf 8 , Rosanna Satta 9 , Bernard Cribier 10 , Laurence Gusdorf 11 , Maria Teresa Rossi 12 , Piergiacomo Calzavara-Pinton 12 , Isabel Bielsa 13 , Maria Teresa Fernandez-Figueras 14 , Werner Kempf 15 , Giorgio Filosa 16 , Luca Pilloni 17 , Franco Rongioletti 18
Affiliation  

BACKGROUND Clinical and pathologic criteria to distinguish drug-induced subacute lupus erythematosus (DI-SCLE) from idiopathic (I-SCLE) are controversial. OBJECTIVE The aim of the survey was a retrospective analysis of a consistent number of iatrogenous and idiopathic SCLE cases, by means of clinical and histopathologic investigation. METHODS Eleven European university dermatology units collected all diagnosed cases from January 2000 to December 2016. Board-certified dermatopathologists reviewed the histopathologic specimens. Statistical analysis included Student t test, exact test of goodness-of-fit, Fisher's exact test, and the Cochran-Mantel-Haenszel test for repeated measures. RESULTS Out of 232 patients, 67 (29%) belonged to the DI-SCLE group. Patients with DI-SCLE were significantly older and reported more systemic symptoms than those with I-SCLE. No statistical differences were found for presentation pattern or serology, while histopathology showed a significant association of mucin deposition (P = .000083), direct immunofluorescence positivity for granular immunoglobulin M, and C3 deposits on the basement membrane zone (P = .0041) for I-SCLE and of leukocytoclastic vasculitis (P = .0018) for DI-SCLE. LIMITATIONS This is a retrospective study. CONCLUSION An integrated clinical and immunopathologic evaluation is useful to differentiate I-SCLE from DI-SCLE. Older age at onset and more frequent systemic symptoms characterize DI-SCLE. Mucin deposition and immunofluorescence findings are found in I-SCLE, and leukocytoclastic vasculitis is found in DI-SCLE.

中文翻译:

是否有区别于药物性亚急性皮肤性红斑狼疮的特发性临床和病理特征?欧洲一项回顾性多中心研究。

背景技术区分药物诱发的亚急性红斑狼疮(DI-SCLE)与特发性(I-SCLE)的临床和病理学标准是有争议的。目的调查的目的是通过临床和组织病理学调查回顾性分析一致数量的医源性和特发性SCLE病例。方法从2000年1月至2016年12月,欧洲11个大学的皮肤科病房收集了所有确诊病例。经董事会认证的皮肤病理学家对组织病理学标本进行了检查。统计分析包括学生t检验,拟合优度的精确检验,Fisher的精确检验以及用于重复测量的Cochran-Mantel-Haenszel检验。结果在232名患者中,有67名(29%)属于DI-SCLE组。与I-SCLE相比,DI-SCLE患者的年龄明显偏大,并报告了更多的全身症状。没有发现表现形式或血清学上的统计学差异,而组织病理学显示粘蛋白沉积(P = .000083),颗粒免疫球蛋白M的直接免疫荧光阳性和基底膜区C3沉积的显着相关性(P = .0041)。 I-SCLE和DI-SCLE的白细胞碎裂性血管炎(P = .0018)。局限性这是一项回顾性研究。结论综合的临床和免疫病理学评估有助于区分I-SCLE和DI-SCLE。DI-SCLE的发病年龄较大,全身症状更为频繁。在I-SCLE中发现粘蛋白沉积和免疫荧光发现,在DI-SCLE中发现白细胞碎裂性血管炎。没有发现表现形式或血清学上的统计学差异,而组织病理学显示粘蛋白沉积(P = .000083),颗粒免疫球蛋白M的直接免疫荧光阳性和基底膜区C3沉积的显着相关性(P = .0041)。 I-SCLE和白细胞碎裂性血管炎(P = 0.0018)适用于DI-SCLE。局限性这是一项回顾性研究。结论综合的临床和免疫病理学评估有助于区分I-SCLE和DI-SCLE。DI-SCLE的发病年龄较大,全身症状更为频繁。在I-SCLE中发现粘蛋白沉积和免疫荧光发现,在DI-SCLE中发现白细胞碎裂性血管炎。没有发现表现形式或血清学上的统计学差异,而组织病理学显示粘蛋白沉积(P = .000083),颗粒免疫球蛋白M的直接免疫荧光阳性和基底膜区C3沉积的显着相关性(P = .0041)。 I-SCLE和DI-SCLE的白细胞碎裂性血管炎(P = .0018)。局限性这是一项回顾性研究。结论综合的临床和免疫病理学评估有助于区分I-SCLE和DI-SCLE。DI-SCLE的发病年龄较大,全身症状更为频繁。在I-SCLE中发现粘蛋白沉积和免疫荧光发现,在DI-SCLE中发现白细胞碎裂性血管炎。000083),I-SCLE颗粒免疫球蛋白M的直接免疫荧光阳性和C3沉积在基底膜区(P = .0041),DI-SCLE则是白细胞碎裂性血管炎(P = .0018)。局限性这是一项回顾性研究。结论综合的临床和免疫病理学评估有助于区分I-SCLE和DI-SCLE。DI-SCLE的发病年龄较大,全身症状更为频繁。在I-SCLE中发现粘蛋白沉积和免疫荧光发现,在DI-SCLE中发现白细胞碎裂性血管炎。000083),I-SCLE颗粒免疫球蛋白M的直接免疫荧光阳性和C3沉积在基底膜区(P = .0041),DI-SCLE则是白细胞碎裂性血管炎(P = .0018)。局限性这是一项回顾性研究。结论综合的临床和免疫病理学评估有助于区分I-SCLE和DI-SCLE。DI-SCLE具有发病年龄大和全身症状多的特点。在I-SCLE中发现粘蛋白沉积和免疫荧光发现,在DI-SCLE中发现白细胞碎裂性血管炎。结论综合的临床和免疫病理学评估有助于区分I-SCLE和DI-SCLE。DI-SCLE具有发病年龄大和全身症状多的特点。在I-SCLE中发现粘蛋白沉积和免疫荧光发现,在DI-SCLE中发现白细胞碎裂性血管炎。结论综合的临床和免疫病理学评估有助于区分I-SCLE和DI-SCLE。DI-SCLE具有发病年龄大和全身症状多的特点。在I-SCLE中发现粘蛋白沉积和免疫荧光发现,在DI-SCLE中发现白细胞碎裂性血管炎。
更新日期:2019-07-12
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