Chilblain lupus erythematosus is associated with antibodies to SSA/Ro.
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.
Franceschini
F
F
Clinical Immunology Unit, Spedali Civili, Brescia, Italy. doff@numerica.it
Calzavara-Pinton
P
P
Quinzanini
M
M
Cavazzana
I
I
Bettoni
L
L
Zane
C
C
Facchetti
F
F
Airò
P
P
McCauliffe
D P
DP
Cattaneo
R
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D000974:Antibodies, Antinuclear / Q000097:blood*; D000918:Antibody Specificity; D002647:Chilblains / Q000150:complications* / Q000276:immunology*; D002648:Child; D005260:Female; D006801:Humans; D008178:Lupus Erythematosus, Cutaneous / Q000150:complications* / Q000276:immunology*; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000276:immunology*; D008297:Male; D008875:Middle Aged
D000974:Antibodies, Antinuclear; C035356:SS-A antibodies