title: Cutaneous characteristics and association with antinuclear antibodies in 402 patients with different subtypes of lupus erythematosus.
abstract: BACKGROUND
  Lupus erythematosus (LE) is an autoimmune disease characterized by a heterogeneous spectrum of skin manifestations and organ affection, and is frequently associated with serum autoantibodies, which mostly remain positive through the course of the disease. The classification of LE is still a controversial topic.
  
  
  OBJECTIVE
  To examine the prevalence and long-term course of autoantibodies in patients with cutaneous LE (CLE) and/or systemic LE (SLE) treated in the outpatient clinic for connective tissue diseases of the department of Dermatology in Bochum, Germany.
  
  
  METHODS
  Four hundred and two patients with LE were evaluated for antinuclear antibodies at a whole of 1572 time points. The prevalence as well as the long-term positivity of antinuclear antibodies and their correlation with the various subtypes of disease was examined.
  
  
  RESULTS
  Antinuclear antibody (ANA) testing and anti-ds-DNA antibodies were not only more prevalent in SLE patients (as expected from the ACR criteria for diagnosis of SLE, P < 0.0001), but also have had a more consistent course in the long-term evaluation (P = 0.0001 and P = 0.0111 respectively). Subacute cutaneous LE (SCLE) was associated with ANA (P = 0.0075), anti-Ro (P < 0.0001) and anti-La (P < 0.0001) antibodies, showing also higher consistency rates for these antibodies than discoid LE (DLE, P = 0.049, P = 0.004, P = 0.0004). Our data from 100 patients with LE tumidus (LET) support its perception as a distinct subtype of LE, not correlating with systemic disease or antinuclear antibodies (P < 0.0001). Anti-U1-ribonucleoprotein antibodies correlated with CLE in SLE patients (P = 0.0237), whereas non-LE-specific antinuclear antibodies were a rare, inconsistent autoimmune epiphenomenon in patients with SLE.
  
  
  CONCLUSIONS
  Long-term analysis of antinuclear antibodies has shown significant differences in various clinical subtypes of LE, confirming the actual classification of the disease. A serial evaluation of antinuclear antibodies may support the classification of disease in LE patients with overlapping clinical features.
authors.affiliation: Connective tissue disease research unit of the Department of Dermatology, Venereology, and Allergology, Ruhr-University Bochum, Bochum, Germany.
authors.forename: N
authors.initials: N
authors.lastname: Patsinakidis
authors.affiliation: Connective tissue disease research unit of the Department of Dermatology, Venereology, and Allergology, Ruhr-University Bochum, Bochum, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Gambichler
authors.affiliation: Connective tissue disease research unit of the Department of Dermatology, Venereology, and Allergology, Ruhr-University Bochum, Bochum, Germany.
authors.forename: N
authors.initials: N
authors.lastname: Lahner
authors.affiliation: Connective tissue disease research unit of the Department of Dermatology, Venereology, and Allergology, Ruhr-University Bochum, Bochum, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Moellenhoff
authors.affiliation: Connective tissue disease research unit of the Department of Dermatology, Venereology, and Allergology, Ruhr-University Bochum, Bochum, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Kreuter
mesh_terms: D000974:Antibodies, Antinuclear / Q000276:immunology*; D006801:Humans; D008178:Lupus Erythematosus, Cutaneous / Q000276:immunology*
chemical_list: D000974:Antibodies, Antinuclear