Advertisement

Rheumaderm pp 167-171 | Cite as

Chilblain Lupus Erythematosus is Associated with Antibodies to SSA/Ro

  • Franco Franceschini
  • P. Calzavara-Pinton
  • L. Valsecchi
  • M. Quinzanini
  • C. Zane
  • F. Facchetti
  • P. Airò
  • R. Cattaneo
Chapter
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 455)

Abstract

Chillblain Lupus Erythematosus (CL) of Hutchinson is a subtype of Lupus Erythematosus characterized by erythematous lesions symmetrically distributed on the face, nose, fingers and toes, knees and heels. The lesions are induced by cold, damp climates. A number of patients affected by CL eventually develop features of Systemic Lupus Erythematosus (SLE).

We report here 7 patients, all but one affected by SLE, with chilblain cutaneous lesions on their hands, feet and face. The onset of CL preceded the diagnosis of SLE, from 1 to 10 years in 3 cases, it was concurrent in one case and was subsequent in the other 2 cases. Six out of the seven patients referred typical Raynaud’s phenomenon and one had acrocyanosis. CL lesions developed and were aggravated by the cold during autumn and winter, they improved during summer. Skin biopsy performed in 5 patients from the lesions showed, on histology, a typical pattern of alterations with granular deposits at the dermo-epidermal junction on direct immunofluorescence. Laboratory findings showed: ANA and anti-SSA/Ro were detected in all the patients, anti-SSA/Ro were isolated in 4 patients and associated with anti-Sm in one case, anti-U1 RNP in one case and with anti- Sm and anti-RNP in a third case. Complement consumption was observed in 5 patients, anti-dsDNA in the six patients with SLE, hypergammaglobulinemia in 4 and rheumatoid factor in one. The fine specificity of anti-SSA/Ro as determined by immunoblotting using a human spleen extract as a substrate, showed: anti-60kD and anti-52 kD in two sera, anti- 60kD isolated in 2 sera, anti-52kD isolated in one serum (from the patient without SLE) while 2 sera did not blotted.

In conclusion, our study confirms the previous report of anti-SSA/Ro antibodies in association with CL. This clinical and serologic association widens the spectrum of cutaneous disease that is associated with antibodies to SSA/Ro to include conditions such as to SCLE, hypergammaglobulinemic purpura and neonatal lupus.

Keywords

Systemic Lupus Erythematosus Fine Specificity Neonatal Lupus Nailfold Capillaroscopy Chilblain Lupus 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Hutchinson J. Harveian lectures on lupus. The varieties of common lupus. Br Med J 1: 58–63 (1988).CrossRefGoogle Scholar
  2. 2.
    Aoki T, Ishizawa T, Hozumi Y, Aso K, Kondo S. Chilblain lupus erythematosus of Hutchinson responding to surgical treatment: a report of two patients with anti-Ro/SS-A antibodies. Br J Dermatol 134: 533–7 (1996).PubMedCrossRefGoogle Scholar
  3. 3.
    Su WP, Perniciaro C, Rogers RS 3rd, White JW Jr. Chilblain lupus erythematosus (lupus pernio): Clinical review of the Mayo Clinic experience and proposal of diagnostic criteria. Cutis 54: 395–9 (1994).PubMedGoogle Scholar
  4. 4.
    Bernstein RM, Bunn CC, Hughes GRV. Identification of antibodies to acidic antigens by counterimmu-noelectrophoresis Ann Rheum Dis 41: 554–5 (1982).PubMedCrossRefGoogle Scholar
  5. 5.
    Doutre MS, Beylot C, Beylot J, Pompougnac E, Royer P. Chilblain lupus erythematosus: report of 15 cases. Dermatology 184: 26–8 (1992).PubMedCrossRefGoogle Scholar
  6. 6.
    Millard LG, Rowell NR. Chilblain lupus erythematosus (Hutchinson). A clinical and laboratory study of 17 patients. Br J Dermatol 98: 497–506 (1978).PubMedCrossRefGoogle Scholar
  7. 7.
    Morioka N, Tsuchida T, Ueda Y, Ishibashi Y. Evaluation of the past history of chilblain in cases of systemic lupus erythematosus (SLE) and its similar diseases. Nippon Hifuka Gakkai Zasshi 101: 615–22 (1991).PubMedGoogle Scholar
  8. 8.
    de Argila Fernandez-Auran D; Revenga Arranz F; Iglesias Diez L. Perniosis and lupus anticoagulant. Rev Clin Esp 196: 24–7(1996).Google Scholar

Copyright information

© Springer Science+Business Media New York 1999

Authors and Affiliations

  • Franco Franceschini
    • 1
  • P. Calzavara-Pinton
    • 2
  • L. Valsecchi
    • 1
  • M. Quinzanini
    • 1
  • C. Zane
    • 2
  • F. Facchetti
    • 3
  • P. Airò
    • 1
  • R. Cattaneo
    • 1
  1. 1.Clinical Immunology UnitSpedali CiviliBresciaItaly
  2. 2.Division of DermatologySpedali CiviliBresciaItaly
  3. 3.Pathology UnitSpedali CiviliBresciaItaly

Personalised recommendations