Subacute cutaneous lupus erythematosus in Greece. A clinical, serological and genetic study

We present herein clinical, serological and genetic findings on 27 Greek, subacute cutaneous lupus erythematosus (SCLE) patients. Twenty-three (85 p. 100) presented with a psoriasifom rash in a photosensitive distribution. Two patients (7.5 p. 100) had an annular rash in a polycyclic pattern. Two other patients exhibited both types of lesions. The majority of our patients also had other skin manifestations, including butterfly rash, discoid lesions and maculopapular rash. Systemic manifestations were: arthralgias or arthritis in 50 p. 100, low grade fever in 35 p. 100, central nervous system involvement in 15 p. 100, Sjögren's syndrome in 18 p. 100 and serositis in 8 p. 100. Anti-nuclear antibodies were found in 93 p. 100; antibodies to Ro (SSA) and/or La (SSB) in 70 p. 100. Twenty-one (78 p. 100) satisfied the ARA criteria for systemic lupus erythematosus (SLE). No HLA-DR3 antigen association was found in the 16 patients tested. These findings are somewhat different from those reported previously: a) the frequency of the psoriasiform rash rather than the annular one is the highest in Greek SCLE patients; b) most patients also have other skin manifestations mimicking the full spectrum of SLE with prominent cutaneous lesions; and c) no HLA-DR3 antigen association was found in Greek patients. Environmental, ethnic or genetic factors may be responsible for these differences.