title: Clinicopathological Significance among Patients withIn vivoEpidermal Nuclear Staining by Direct Immunofluorescence Study.
abstract: BACKGROUND
  In vivoepidermal nuclear staining (ENS) can be found in patients with autoimmune connective tissue diseases (CNTDs) and other diseases.
  
  
  OBJECTIVE
  The aim of this study was to reveal the underlying diseases and direct immunofluorescence (DIF) characters of patients within vivoENS and association ofin vivoENS with circulating autoantibodies.
  
  
  METHODS
  A retrospective analysis was conducted involving skin biopsy specimens submitted for DIF study at the Dermatoimmunology Laboratory at Siriraj Hospital between 2002 and 2012.
  
  
  METHODS
  The findings of DIF study, clinical manifestations, and diagnosis of patients who had positive ENS were investigated.
  
  
  METHODS
  The SPSS software version 18.0. Descriptive statistics were used to report demographic data, clinical characteristics, and laboratory investigation results. Moreover, Chi-squared test or Fisher's exact test were used to compare the categorical variables.
  
  
  RESULTS
  One hundred and thirty-eight out of 3735 submitted specimens (3.7%) showed positive ENS. The most common diagnosis was CNTD (79%) followed by vasculitis (10.1%). Lupus erythematosus was the most common diagnosis among CNTD (78%). No association between levels of serum antinuclear antibodies (ANA) titer and intensity of ENS (P= 0.660). However, we found that patients with positivein vivoANA had lower prevalence of systemic involvement.
  
  
  CONCLUSIONS
  Although lupus erythematosus was the most common diagnosis among patients within vivoENS, the presence of ENS does not indicate any specific diagnosis. However, patients with ENS tend to have less systemic involvement.
authors.affiliation: Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Wararat
authors.initials: W
authors.lastname: Sirikudta
authors.affiliation: Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Papapit
authors.initials: P
authors.lastname: Tuchinda
authors.affiliation: Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Leena
authors.initials: L
authors.lastname: Chularojanamontri
authors.affiliation: Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Kanokvalai
authors.initials: K
authors.lastname: Kulthanan
authors.affiliation: Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Samruay
authors.initials: S
authors.lastname: Pinkaew
keywords: Autoantibodies; epidermal nuclear staining; in vivo antinuclear antibody; in vivo epidermal nuclear staining autoantibodies