title: Three cases of pigmented cosmetic dermatitis-like eruptions associated with primary Sjögren's syndrome or anti-SSA antibody.
abstract: Pigmented cosmetic dermatitis-like (Riehl's melanosis-like) pigmentation was reported in three of 27 patients with primary Sjögren's syndrome. But case reports of such eruptions are rare. We describe three cases of such eruptions associated with primary Sjögren's syndrome or anti-SSA antibody and possible associations with specific types of human leukocyte antigen (HLA) and infiltrating lymphocytes. These middle-aged Japanese women had reticular facial pigmentation and histopathological examination revealed interface dermatitis, melanophages, and dense lymphocytic infiltration around hair follicles and sweat ducts. HLA typing revealed common antigenic equivalents or genetic typing of HLA-A2, DR52, DPA1(02:02) and DPB1(05:01). Immunohistochemical staining revealed major subsets of T cells to be CD8 and CD45RO. Some Foxp3- and few IL17-positive cells were found in strong contrast to the major CD4 subset of infiltrated T cells in annular erythema associated with Sjögren's syndrome. Apparently, our patients' pigmentation represented a specific etiology associated with primary Sjögren's syndrome or anti-SSA antibody.
authors.affiliation: Department of Dermatology, Oita University, Kyoto, Japan.
authors.forename: Naoko
authors.initials: N
authors.lastname: Takeo
authors.affiliation: Department of Dermatology, Oita University, Kyoto, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Sakai
authors.affiliation: Department of Dermatology, Oita University, Kyoto, Japan.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Saito-Shono
authors.affiliation: Department of Dermatology, Oita University, Kyoto, Japan.
authors.forename: Kazushi
authors.initials: K
authors.lastname: Ishikawa
authors.affiliation: Department of Dermatology, Oita University, Kyoto, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Hatano
authors.affiliation: Department of Dermatology, Oita University, Kyoto, Japan.
authors.forename: Kazumoto
authors.initials: K
authors.lastname: Katagiri
authors.affiliation: Department of Oral and Maxillo-Facial Surgery, Oita University, Kyoto, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Takahashi
authors.affiliation: Department of Oral and Maxillo-Facial Surgery, Oita University, Kyoto, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Kawano
authors.affiliation: Department of Ophthalmology, Oita University, Kyoto, Japan.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Kimoto
authors.affiliation: Department of Ophthalmology, Oita University, Kyoto, Japan.
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Kubota
authors.affiliation: Department of Biostatistics, Faculty of Medicine, Oita University, Kyoto, Japan.
authors.forename: Nobuoki
authors.initials: N
authors.lastname: Eshima
authors.affiliation: HLA Foundation Laboratory, Kyoto, Japan.
authors.forename: Hiroto
authors.initials: H
authors.lastname: Kojima
authors.affiliation: Department of Dermatology, Oita University, Kyoto, Japan.
authors.forename: Sakuhei
authors.initials: S
authors.lastname: Fujiwara
mesh_terms: D000368:Aged; D000974:Antibodies, Antinuclear / Q000097:blood*; D003872:Dermatitis / Q000209:etiology / Q000276:immunology* / Q000473:pathology*; D005260:Female; D006650:Histocompatibility Testing; D006801:Humans; D008875:Middle Aged; D010859:Pigmentation Disorders / Q000209:etiology / Q000276:immunology / Q000473:pathology; D012859:Sjogren's Syndrome / Q000150:complications / Q000276:immunology / Q000473:pathology*
chemical_list: D000974:Antibodies, Antinuclear; C035356:SS-A antibodies
keywords: Riehl's melanosis; anti-SSA antibody; human leukocyte antigen typing; pigmented cosmetic dermatitis-like eruption; primary Sjögren's syndrome