Are there distinct clinical and pathological features distinguishing idiopathic from drug-induced subacute cutaneous lupus erythematosus? A European retrospective multicenter study
Por:
Guicciardi, F, Atzori, L, Marzano, AV, Tavecchio, S, Girolomoni, G, Colato, C, Villani, AP, Kanitakis, J, Mitteldorf, C, Satta, R, Cribier, B, Gusdorf, L, Rossi, MT, Calzavara-Pinton, P, Bielsa, I, Fernandez-Figueras, MT, Kempf, W, Filosa, G, Pilloni, L and Rongioletti, F
Publicada:
1 ago 2019
Ahead of Print:
11 feb 2019
Categoría:
Dermatology
Resumen:
Background: Clinical and pathologic criteria to distinguish drug-induced subacute lupus erythematosus (DI-SCLE) from idiopathic (I-SCLE) are controversial.
Objective: The aim of the survey was a retrospective analysis of a consistent number of iatrogenous and idiopathic SCLE cases, by means of clinical and histopathologic investigation.
Methods: Eleven European university dermatology units collected all diagnosed cases from January 2000 to December 2016. Board-certified dermatopathologists reviewed the histopathologic specimens. Statistical analysis included Student t test, exact test of goodness-of-fit, Fisher's exact test, and the Cochran-Mantel-Haenszel test for repeated measures.
Results: Out of 232 patients, 67 (29%) belonged to the DI-SCLE group. Patients with DI-SCLE were significantly older and reported more systemic symptoms than those with I-SCLE. No statistical differences were found for presentation pattern or serology, while histopathology showed a significant association of mucin deposition (P = .000083), direct immunofluorescence positivity for granular immunoglobulin M, and C3 deposits on the basement membrane zone (P = .0041) for I-SCLE and of leukocytoclastic vasculitis (P = .0018) for DI-SCLE.
Limitations: This is a retrospective study.
Conclusion: An integrated clinical and immunopathologic evaluation is useful to differentiate I-SCLE from DI-SCLE. Older age at onset and more frequent systemic symptoms characterize DI-SCLE. Mucin deposition and immunofluorescence findings are found in I-SCLE, and leukocytoclastic vasculitis is found in DI-SCLE.
Filiaciones:
Guicciardi, F:
Univ Cagliari, Dept Dermatol Med Sci & Publ Hlth, Cagliari, Italy
Atzori, L:
Univ Cagliari, Dept Dermatol Med Sci & Publ Hlth, Cagliari, Italy
Italian Soc Dermatol, SIDEMAST Dermatopathol Study Grp, Brescia, Italy
Marzano, AV:
Univ Milan, Dermatol Unit, Fdn IRCCS Ca Granda Osped Maggiore Policlin, Dept Pathophysiol & Transplantat, Milan, Italy
Tavecchio, S:
Univ Milan, Dermatol Unit, Fdn IRCCS Ca Granda Osped Maggiore Policlin, Dept Pathophysiol & Transplantat, Milan, Italy
Girolomoni, G:
Univ Verona, Dept Med, Sect Dermatol, Verona, Italy
Colato, C:
Univ Verona, Dept Pathol, Sect Diagnost & Publ Hlth, Verona, Italy
Villani, AP:
Ed Herriot Hosp Grp Pav R, Dept Dermatol, Lyon, France
Kanitakis, J:
Ed Herriot Hosp Grp Pav R, Dept Dermatol, Lyon, France
EADV, Task Force Dermatopathol, Lugano, Switzerland
Mitteldorf, C:
HELIOS Klinikum Hildesheim, Hildesheim, Germany
Univ Med Ctr Gottingen, Dept Dermatol Venereol & Allergol, Gottingen, Germany
Satta, R:
Univ Sassari, Dept Dermatol Clin & Sperimental Med, Sassari, Italy
Italian Soc Dermatol, SIDEMAST Dermatopathol Study Grp, Brescia, Italy
Cribier, B:
CHU Strasbourg, Hop Civil, Serv Dermatol, Strasbourg, France
EADV, Task Force Dermatopathol, Lugano, Switzerland
Gusdorf, L:
CHU Strasbourg, Hop Civil, Serv Dermatol, Strasbourg, France
Rossi, MT:
Univ Brescia, Dept Dermatol, Brescia, Italy
Calzavara-Pinton, P:
Univ Brescia, Dept Dermatol, Brescia, Italy
:
Hosp Badalona Germans Trias & Pujol, Dept Dermatol, Badalona, Spain
Fernandez-Figueras, MT:
Univ Autonoma Barcelona, Hosp Univ Gen Catalunya, Grp Quiron Salud, Patol Quirurg,Anat Patol, Barcelona, Spain
EADV, Task Force Dermatopathol, Lugano, Switzerland
Kempf, W:
Histol Diagnost, Kempf & Pfaltz, Zurich, Switzerland
EADV, Task Force Dermatopathol, Lugano, Switzerland
Filosa, G:
UOC Dermatol, Jesi, Italy
Italian Soc Dermatol, SIDEMAST Dermatopathol Study Grp, Brescia, Italy
Pilloni, L:
Univ Cagliari, Dept Surg Sci, Pathol Serv, Cagliari, Italy
Rongioletti, F:
Univ Cagliari, Dept Dermatol Med Sci & Publ Hlth, Cagliari, Italy
EADV, Task Force Dermatopathol, Lugano, Switzerland
Italian Soc Dermatol, SIDEMAST Dermatopathol Study Grp, Brescia, Italy
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