Are there distinct clinical and pathological features distinguishing idiopathic from drug-induced subacute cutaneous lupus erythematosus? A European retrospective multicenter study

Federica Guicciardi, Laura Atzori, Angelo Valerio Marzano, Simona Tavecchio, Giampiero Girolomoni, Chiara Colato, Axel Patrice Villani, Jean Kanitakis, Christina Mitteldorf, Rosanna Satta, Bernard Cribier, Laurence Gusdorf, Maria Teresa Rossi, Piergiacomo Calzavara-Pinton, Isabel Bielsa, Maria Teresa Fernandez-Figueras, Werner Kempf, Giorgio Filosa, Luca Pilloni, Franco Rongioletti

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Abstract

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.

Original languageEnglish
Pages (from-to)403-411
JournalJournal of the American Academy of Dermatology
Volume81
Issue number2
DOIs
Publication statusPublished - Jan 1 2019

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Cutaneous Lupus Erythematosus
Multicenter Studies
Retrospective Studies
Pharmaceutical Preparations
Mucins
Direct Fluorescent Antibody Technique
Serology
Dermatology
Age of Onset
Basement Membrane
Fluorescent Antibody Technique
Immunoglobulin M
Students

Keywords

  • drug-induced subacute lupus erythematosus
  • histopathology study
  • subacute lupus erythematosus

ASJC Scopus subject areas

  • Dermatology

Cite this

Are there distinct clinical and pathological features distinguishing idiopathic from drug-induced subacute cutaneous lupus erythematosus? A European retrospective multicenter study. / Guicciardi, Federica; Atzori, Laura; Marzano, Angelo Valerio; Tavecchio, Simona; Girolomoni, Giampiero; Colato, Chiara; Villani, Axel Patrice; Kanitakis, Jean; Mitteldorf, Christina; Satta, Rosanna; Cribier, Bernard; Gusdorf, Laurence; Rossi, Maria Teresa; Calzavara-Pinton, Piergiacomo; Bielsa, Isabel; Fernandez-Figueras, Maria Teresa; Kempf, Werner; Filosa, Giorgio; Pilloni, Luca; Rongioletti, Franco.

In: Journal of the American Academy of Dermatology, Vol. 81, No. 2, 01.01.2019, p. 403-411.

Research output: Contribution to journalArticle

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 & Rongioletti, F 2019, 'Are there distinct clinical and pathological features distinguishing idiopathic from drug-induced subacute cutaneous lupus erythematosus? A European retrospective multicenter study', Journal of the American Academy of Dermatology, vol. 81, no. 2, pp. 403-411. https://doi.org/10.1016/j.jaad.2019.02.009
Guicciardi, Federica ; Atzori, Laura ; Marzano, Angelo Valerio ; Tavecchio, Simona ; Girolomoni, Giampiero ; Colato, Chiara ; Villani, Axel Patrice ; Kanitakis, Jean ; Mitteldorf, Christina ; Satta, Rosanna ; Cribier, Bernard ; Gusdorf, Laurence ; Rossi, Maria Teresa ; Calzavara-Pinton, Piergiacomo ; Bielsa, Isabel ; Fernandez-Figueras, Maria Teresa ; Kempf, Werner ; Filosa, Giorgio ; Pilloni, Luca ; Rongioletti, Franco. / Are there distinct clinical and pathological features distinguishing idiopathic from drug-induced subacute cutaneous lupus erythematosus? A European retrospective multicenter study. In: Journal of the American Academy of Dermatology. 2019 ; Vol. 81, No. 2. pp. 403-411.
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abstract = "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.",
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T1 - Are there distinct clinical and pathological features distinguishing idiopathic from drug-induced subacute cutaneous lupus erythematosus? A European retrospective multicenter study

AU - Guicciardi, Federica

AU - Atzori, Laura

AU - Marzano, Angelo Valerio

AU - Tavecchio, Simona

AU - Girolomoni, Giampiero

AU - Colato, Chiara

AU - Villani, Axel Patrice

AU - Kanitakis, Jean

AU - Mitteldorf, Christina

AU - Satta, Rosanna

AU - Cribier, Bernard

AU - Gusdorf, Laurence

AU - Rossi, Maria Teresa

AU - Calzavara-Pinton, Piergiacomo

AU - Bielsa, Isabel

AU - Fernandez-Figueras, Maria Teresa

AU - Kempf, Werner

AU - Filosa, Giorgio

AU - Pilloni, Luca

AU - Rongioletti, Franco

PY - 2019/1/1

Y1 - 2019/1/1

N2 - 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.

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