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Annular erythema associated with lupus erythematosus/Sjögren's syndrome
T Watanabe1, T Tsuchida, Y Ito
1Department of Dermatology, Faculty of Medicine, University of Tokyo, Japan.
Background:
Annular-polycyclic and papulosquamous lesions are associated with subacute cutaneous lupus erythematosus (SCLE). In some Asian cases, annular erythema has been associated with Sjögren's syndrome (SS). However, the relation between the two is unclear.
Objective:
Our purpose was to clarify the clinical manifestations and immunologic features of patients with annular erythema.
Methods:
This study included 15 patients with annular erythema. Systemic, serologic, and genetic findings were analyzed.
Results:
Histologic examination showed perivascular and periappendageal lymphocytic infiltrates in all patients. However, LE-specific epidermal changes were observed in only three (20%). Although all patients at least partially demonstrated features of LE or SS, eight (53%) fulfilled the American Rheumatism Association criteria for systemic LE (SLE) and five (33%) were diagnosed with SS. Renal (20%) and central nervous system (7%) involvement was observed. Anti-Ro(SS-A) and anti-La(SS-B) antibodies were detected in nine (60%) and seven (47%) patients, respectively. There were no histocompatibility antigen (HLA) haplotype differences.
Conclusion:
Annular erythema in Asian patients is the counterpart of subacute skin lesions of LE in whites, except for the paucity of LE-specific histopathologic findings and HLA-DR3 tissue type.