Subacute Cutaneous Lupus Erythematosus

Proven Lupus Treatment By Dr Gary Levin

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The composition and pattern of immune deposits in lesional SCLE skin are similar to those seen in DLE (Meurer and Bieber 1987). The LBT in lesional skin is positive in 60%-100% of biopsy samples from SCLE lesions; the frequency may vary with the

Table 22.1. Direct immunofluorescence findings (IgG) in lupus erythematosus (LE)

Disease

Lesional LBT (%)

Nonlesional, sun-protected LBT (%)

Chronic discoid LE

60-90

0

Subacute cutaneous LE

60-100

0

Systemic LE

90-100

50-90

LBT, lupus band test.

LBT, lupus band test.

Fig. 22.1. Linear, bandlike deposits of IgM along the dermoepider-mal junction of a chronic discoid lupus erythematosus lesion

Subacute Cutaneous Lupus Lesions

Fig. 22.1. Linear, bandlike deposits of IgM along the dermoepider-mal junction of a chronic discoid lupus erythematosus lesion

Fig. 22.2. Granular deposits of C3 along the dermoepidermal junction of a chronic discoid lupus erythema-tosus lesion (a similar pattern is often seen in a false-positive lupus band test result in nonlupus erythematosus inflammatory diseases) (Table 22.2)

Fig. 22.2. Granular deposits of C3 along the dermoepidermal junction of a chronic discoid lupus erythema-tosus lesion (a similar pattern is often seen in a false-positive lupus band test result in nonlupus erythematosus inflammatory diseases) (Table 22.2)

Lupus Band Test Results

duration of the subacute inflammatory skin lesions and with the anatomic location (Kay and Tuffanelli 1969). Unique to SCLE is a granular fluorescence seen in some patients with SCLE in the cytoplasm and in the nuclei of basal keratinocytes. This fluorescence pattern is thought to be caused by the binding of anti-Ro/SSA or anti-La/SSB antibodies to their respective cytoplasmic or nuclear antigens (Baleski et al. 1992). The LBT result in nonlesional sun-protected skin of patients with SCLE is negative in most cases; positive results, particularly when IgG deposits are found, point to an overlap with SLE (Sontheimer and Provost 1997).

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