bromochloroacetic-acid and Lupus-Erythematosus--Cutaneous

Skin eruptions with features of subacute cutaneous lupus erythematosus occurred in a patient with dermatomyositis who was taking griseofulvin. The patient had antibodies against SSA/Ro and SSB/La antigens. Skin rashes disappeared after discontinuation of griseofulvin and recurred on challenge with the drug. These findings support previous studies that the photoactive drug may be synergistic with anti-SSA/Ro antibody to produce lesions of subacute cutaneous lupus erythematosus.

Topics: Adult; Biopsy; Dermatomyositis; Drug Eruptions; Female; Griseofulvin; Humans; Keratins; Lupus Erythematosus, Cutaneous; Skin

Skin biopsies from 13 patients with papular lesions thought to be cutaneous lupus erythematosus were analyzed by light microscopy, direct immunofluorescence and immunohistochemically and compared to 22 biopsies from patients with discoid lupus, subacute cutaneous lupus erythematosus and acute cutaneous lesions of SLE. Papular lesions demonstrated fewer florid dermal and epidermal changes but a similar marked mononuclear cell infiltrate which in all groups was composed predominantly of T lymphocytes (68.4 +2- 11.2 SD) with the mean helper: suppressor (corrected Leu 3a:T8) ratio 1.73 +/- 0.60 SD. HLA-DR expression on keratinocytes was present in 20 patients, including 4 with papular lesions, and was strongly associated with liquefactive degeneration (chi 2, p less than 0.001), the hallmark of dermoepidermal junctional damage.

Topics: Antibodies, Antinuclear; Antibodies, Monoclonal; DNA; Epidermis; Fluorescent Antibody Technique; HLA-DR Antigens; Humans; Keratins; Langerhans Cells; Lupus Erythematosus, Cutaneous; T-Lymphocytes