Sjogren's syndrome (SS) can be associated with all connective tissue diseases. The overlap syndromes of SS and other dermatoses, LE included, form a distinct subtype in the classification of SS. The incidence of SS in connective tissue diseases is different. Mostly, this association appears in systemic sclerosis. Immunologic markers of SS, anti-Ro/SSA and anti-La/SSB antibodies, occur in all connective tissue diseases, sometimes without clinical evidence. Provost et al. (Provost et al. 1988) postulated that there is a relation between SS with anti-Ro/SSA and LE with anti-Ro/SSA antibodies. In SLE, anti-La/SSB occurs in approximately 15% of patients, and most have SS and may be diagnosed as having SS-SLE overlap syndromes. Anti-Ro/SSA (without anti-La/SSB) occurs in approximately 30% of patients with SLE without dry eyes or mouth. SS can precede LE by years, but LE can precede the appearance of SS also. Anti-Ro/SSA antibodies etc found in polymyositis, scleroderma, and primary biliary cirrhosis, and association with SS is invariably (Venables 1988). The skin changes associated with SS include dry eyes, dry mouth, and dry genitals as major clinical symptoms. Other clinical symptoms include annular erythema, Sweet's syndrome-like lesions, vitiligo-like changes, sarcoidosis, and LP-like and amyloidosis nodularis-like symptoms (Ueki 1994, personal communication). Annular erythema is one of the prominent clinical features of both SS and SLE. Katayama et al. (Katayama et al. 1991) subdivided annular erythema into three types. Type I is an isolated annular erythema with an elevated and exudative border. Sometimes slight scale occurs on the overlying erythema. This type may form a polycyclic lesion. Type II is a less exudative and marginally scaled erythema that resembles SCLE. Type III is a papular erythema that usually appears as multiple cutaneous lesions and that disappears in a short period compared with the other two types. Since annular erythema is a prominent clinical picture of SS and SCLE, the article by Ruzicka et al. (Ruzicka et al. 1991) deserves attention. They described a patient with annular erythema and SS but with characteristics of SLE.
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Rosacea and Eczema are two skin conditions that are fairly commonly found throughout the world. Each of them is characterized by different features, and can be both discomfiting as well as result in undesirable appearance features. In a nutshell, theyre problems that many would want to deal with.