title: A serology-based approach combined with clinical examination of 125 Ro/SSA-positive patients to define incidence and prevalence of subacute cutaneous lupus erythematosus.
abstract: OBJECTIVE
  To estimate the incidence and prevalence of Ro/SSA-positive subacute cutaneous lupus erythematosus (SCLE) in Stockholm County, Sweden (1.8 million inhabitants) and to investigate the frequency of photosensitivity and other clinical manifestations associated with Ro/SSA autoantibodies.
  
  
  METHODS
  Ro/SSA-positive patients in Stockholm were identified via registry-based searches. All patients who tested positive for the presence of Ro/SSA autoantibodies during 1996-2002 (n = 1,323; 85% women) were identified. A questionnaire was sent to all patients still living in Stockholm in 2003 (n = 1,048). Patients who reported having skin symptoms and photosensitivity (n = 125) underwent a clinical examination.
  
  
  RESULTS
  Of the 741 (71%) of 1,048 Ro/SSA-positive patients who responded to the questionnaire, 400 (54%) reported having photosensitivity, and of these patients, 125 agreed to be clinically examined. A diagnosis of LE was confirmed in 59 of the 125 patients (SCLE in 20, systemic LE [SLE] in 33, and chronic CLE in 6). Eighty-six patients reported experiencing symptoms consistent with polymorphous light eruption (PLE). Comorbidities such as cardiovascular disease, autoimmune disease, and other skin diseases were common. The incidence of Ro/SSA-positive SCLE during the study period was estimated to be 0.7 cases per 100,000 persons per year and the prevalence was approximately 6.2-14 in 100,000 persons.
  
  
  CONCLUSIONS
  The incidence of Ro/SSA-positive SCLE in Stockholm County, Sweden is estimated to be 0.7 per 100,000 persons per year as compared with an incidence of SLE in Sweden of 4.8 per 100,000 persons per year. The prevalence is estimated to be 6.2-14 in 100,000 persons. Self-reported photosensitivity commonly corresponds to a history of PLE in Ro/SSA-positive patients, even when the clinical profile of SCLE is absent. Photoprotection should therefore be included in the treatment recommendations for these patients.
authors.affiliation: Karolinska Institutet, Stockholm, Sweden. karin.popovic@ki.se
authors.forename: Karin
authors.initials: K
authors.lastname: Popovic
authors.forename: Fredrik
authors.initials: F
authors.lastname: Nyberg
authors.forename: Marie
authors.initials: M
authors.lastname: Wahren-Herlenius
authors.forename: Filippa
authors.initials: F
authors.lastname: Nyberg
mesh_terms: D017677:Age Distribution; D005260:Female; D006801:Humans; D015994:Incidence; D008178:Lupus Erythematosus, Cutaneous / Q000453:epidemiology* / Q000276:immunology* / Q000473:pathology; D008297:Male; D010787:Photosensitivity Disorders / Q000453:epidemiology / Q000276:immunology / Q000473:pathology; D015995:Prevalence; D012261:Ribonucleoproteins / Q000276:immunology*; D016036:Seroepidemiologic Studies; D017678:Sex Distribution; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology; D000099207:SS-A Antigen
chemical_list: D012261:Ribonucleoproteins; D000099207:SS-A Antigen