Antibodies against antigens related to scleroderma in a cohort of patients with morphea

Morphea is a rare fibrosing skin disorder. Antinuclear antibodies (ANA), anti-histone and rheumatoid factor are detected in high rate of morphea cases. Scleroderma-related antibodies are usually absent.

Twenty-one adult patients affected by morphea were examined at the time of enrollment and after 6 months with the assessment of clinical outcome measures of disease severity and damage. Healthy subjects were considered as normal controls while patients affected by systemic sclerosis and other connective tissue diseases (CTD) were considered as pathological controls. Serum samples from all the patients and controls were analyzed for the detection of ANA, anti-nucleosome antibodies, anti-dsDNA and anti-extractable nuclear antigen. Scleroderma-related autoantibodies were searched using a line-blot test.

We enrolled 21 patients affected by morphea. ANA were found in 12 patients (57%). Anti-DNA and anti-nucleosome antibodies were negative in all cases. Systemic sclerosis-specific antibodies were found in 11 morphea patients (52.4%) and one healthy control (6.25%). In patients affected by systemic sclerosis (100%) and different CTD (%), scleroderma-related autoantibodies were more frequently detected than in morphea (52.4%). In morphea, anti-TRIM21/Ro52 antibodies were found in 4 patients (36.4%) and resulted to be the most frequently detected antibodies also in two groups of SSC and CTD.

The high prevalence of ANA and the identification of some antagonists of systemic sclerosis-related autoantibodies, confirm the idea of a significant activation of autoimmune system in morphea.