Development of squamous cell carcinoma in chronic discoid lupus erythematosus: a report of two patients with anti-Ro/SSA antibodies

Breast cancer in lupus

The purpose was to evaluate the frequency of breast cancer (BC) in patients with either systemic (SLE) or incomplete lupus erythematosus (ILE), and possibly to find out immunological differences in patients with and without cancer. 133 consecutive female patients with lupus were included. The records were retrospectively analysed with respect to both malignant disease and routine laboratory parameters (e.g. autoantibodies, white blood cell counts). BC was the most common malignancy that was detected in 50% of female lupus patients with concomitant oncological disease. Other malignancies were significantly less (p < 0.001) frequent. Only ILE-patients had BC or other oncological diseases. The proportion of ILE-patients with SSA- and SSB-autoantibodies was significantly higher (p < 1.5 × 10(-10) and 9.1 × 10(-17)) in those with malignancies than without. The presented data suggest that BC is the most common malignancy in patients with ILE. SLE is no prerequisite to acquire an oncological disease. Immunological disturbances (e.g. SSA- and SSB-autoantibodies) could play a role in the oncogensis.

IgG deposits can be detected in cell nuclei of patients with both lupus erythematosus and malignancy

The purpose was to find immunological disturbances in lupus erythematosus (LE) patients with concomitant malignancy. 159 LE patients have been analyzed. Routine laboratory analyses including screening of serum autoantibodies and analyzing peripheral blood mononuclear cells by using flow cytometry have been performed. Malignant diseases have been revealed in 12 (7.5%) cases. All patients suffered from internal malignancies. LE patients with vs without malignancy had significantly decreased anti-double stranded DNA (16.6 vs 31.6%; p < 0.05) and increased anti-SSA/SSB (83.3 vs 32.2%/26.4%; p < 3 x 10(-12)) antibodies. Patients with neoplastic disease had increased IgG within the cell nuclei (76.6% +/- 9.6 vs 51.8 +/- 4.6%; p < 2 x 10(-7)). IgG penetrating living cells has been shown previously in SLE but has so far not been found in association to LE patients with malignant disease.

Squamous cell carcinoma developing in two Chinese patients with chronic discoid lupus erythematosus: the need for continued surveillance

Squamous cell carcinoma (SCC) is a rare late sequel of chronic discoid lupus erythematosus (CDLE). We report two cases of SCC developing in Chinese patients with CDLE. The first patient had prior biopsies from the same site that showed viral warts and the second patient had multiple histologically confirmed viral warts around the vicinity of the previously excised SCC. In this paper, we emphasize the need to be suspicious of warty lesions on skin afflicted by CDLE, and repeat biopsies should be performed if there is failure to respond to conventional therapy.