1
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Subhadarshani S, Vittitow S. Clinical Image: Annular mucosal plaque of lupus erythematosus (AMPLE): a novel feature in a patient with anti-Ro/La-positive toxic epidermal necrolysis-like lupus erythematosus. ACR Open Rheumatol 2024; 6:428. [PMID: 38682871 PMCID: PMC11246826 DOI: 10.1002/acr2.11677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Accepted: 03/29/2024] [Indexed: 05/01/2024] Open
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2
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Mendoza-Kuznetsova E, Lokianskiene V, Matise-VanHoutan I, Fiskovich O, Olivry T. Figurate erythema in 11 Eastern European sphynx cats. Vet Dermatol 2024; 35:346-353. [PMID: 38284278 DOI: 10.1111/vde.13240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 10/26/2023] [Accepted: 01/16/2024] [Indexed: 01/30/2024]
Abstract
BACKGROUND In humans, figurate erythema (FE) represents a heterogenous group of dermatoses with circular or serpiginous erythematous skin lesions; FE has not been reported in cats. OBJECTIVES To report clinical and histological characteristics and outcomes of FE in sphynx cats from Baltic sea-bordering countries. ANIMALS Eleven client-owned sphynx cats with FE. MATERIALS AND METHODS We recruited cases meeting the following criteria: (i) a sphynx breed, (ii) FE with or without scaling, (iii) a chronic, waxing-and-waning course lasting longer than a month and (iv) an absence of other skin diseases. RESULTS Of 11 cats, there were seven Donskoys, one Peterbald, one Ukrainian Levkoy and two presumed Canadian sphynxes; all except one were males, and the age of onset was <12 months in eight cats. Skin lesions lasted between 1.2 and 56 months, and they consisted of erythematous plaques with a linear-to-serpiginous, annular, gyrate or iris configuration predominating on the trunk and extremities. Scaling was often seen trailing the edge of the centrifugally expanding erythema. All cats were otherwise asymptomatic or mildly pruritic. Dermatophytosis was ruled out by special stains and/or fungal cultures in eight cats. Microscopic lesions revealed focal, mild-to-moderate epidermal hyperplasia and hyperkeratosis, minimal-to-mild dysplasia and subepidermal collagen smudging. Special stains were negative for dermatophytes. The clinical remission of FE was not achieved with diet changes or medical interventions; yet, a spontaneous, transient, partial or complete improvement occurred in most cats. CONCLUSION AND CLINICAL RELEVANCE This is the first report of FE in sphynx cats from Eastern Europe.
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Affiliation(s)
| | | | | | | | - Thierry Olivry
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
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3
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Kobayashi T, Ono Y. Annular Erythema on the Cheeks and Ear Lobes in Sjögren's Syndrome. Am J Med 2023; 136:e193-e194. [PMID: 37148993 DOI: 10.1016/j.amjmed.2023.04.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 04/14/2023] [Indexed: 05/08/2023]
Affiliation(s)
- Takahiro Kobayashi
- Department of General Medicine, National Defense Medical College, Saitama, Japan
| | - Yosuke Ono
- Department of General Medicine, National Defense Medical College, Saitama, Japan.
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4
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Paolino G, Rongioletti F. Annular dermatoses with rheumatologic implications. Clin Dermatol 2023; 41:376-381. [PMID: 37437750 DOI: 10.1016/j.clindermatol.2023.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/14/2023]
Abstract
A wide variety of cutaneous disorders present with annular (ringlike) skin lesions, and some of them carry rheumatologic implications because they may involve the joints or belong to the spectrum of connective tissue diseases. The diagnosis of an annular rheumatologic skin disease is possible with a correct clinicopathologic correlation, with a correct anamnesis of the patient, with the evaluation of systemic symptoms, laboratory and instrumental investigations, and finally with a cutaneous biopsy.
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Affiliation(s)
- Giovanni Paolino
- IRCCS Ospedale San Raffaele, Milan, Italy; Università Vita-Salute San Raffaele, Milan, Italy.
| | - Franco Rongioletti
- IRCCS Ospedale San Raffaele, Milan, Italy; Università Vita-Salute San Raffaele, Milan, Italy
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5
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Chen YH, Liu SW, Wang WM, Chiang CP, Hung CT. Cutaneous annular erythema associated with Sjögren's syndrome successfully treated by baricitinib. DERMATOL SIN 2022. [DOI: 10.4103/1027-8117.355702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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6
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Maurelli M, Colato C, Gisondi P, Girolomoni G. Uncommon non-infectious annular dermatoses. Indian J Dermatol 2022; 67:313. [PMID: 36386081 PMCID: PMC9644792 DOI: 10.4103/ijd.ijd_743_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Several cutaneous diseases can present with annular lesions, making a distinction by physical appearance alone challenging. They can be distinguished into infectious and non-infectious, and common and uncommon annular dermatoses. Common non-infectious diseases include granuloma annulare, urticaria, and subacute lupus erythematosus. In addition, there are rare non-infectious non-neoplastic annular dermatoses whose nosographic attribution is established, including annually recurring erythema annulare centrifugum (EAC) and annular erythema in Sjögren syndrome and others whose nosographic positioning is still debated. They are neutrophilic figurate erythema, palpable migratory arciform erythema, eosinophilic annular erythema, and annular lichenoid dermatitis of youth. Their etiopathogenesis is largely unknown, although immune-mediated mechanisms are likely involved. It is difficult to establish if they are variants of reaction patterns or separate clinic-pathological entities. In fact, EAC and annually recurring EAC may represent different aspects of the same disease. Palpable migratory arciform erythema is hardly distinguishable from EAC deep type, Jessner-Kanof disease, and lupus tumidus. Neutrophilic figurate erythema and eosinophilic figurate erythema are clinically very similar and differing only in the relative proportion of eosinophils and neutrophils.
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7
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Arakawa H, Tanese K, Tanaka R, Murakami K, Sujino K, Miyamoto J, Amagai M, Tanikawa A. Efficacy of hydroxychloroquine for treating annular erythema associated with Sjögren's syndrome. J Dermatol 2021; 48:1526-1532. [PMID: 34254339 DOI: 10.1111/1346-8138.16045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 06/06/2021] [Indexed: 11/27/2022]
Abstract
Annular erythema is one of the cutaneous manifestations of Sjögren's syndrome (SS). Topical corticosteroids and tacrolimus, and oral corticosteroids, have been used as treatments for this condition. However, the safety and efficacy of these treatments remains unsatisfactory, and further development of therapies are desired. In this study, we performed a retrospective analysis of 16 annular erythema associated with SS (AESS) patients treated with hydroxychloroquine (HCQ). Disease activity was assessed using a modified version of the Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI), which we termed the modified CLASI (m-CLASI). HCQ treatment improved AESS lesions in all 16 patients. The mean m-CLASI score was reduced by 85.6% at the 12-week follow-up relative to baseline (p < 0.01). Notably, 60% (6/10 cases) of patients with AESS lesions limited to the facial area achieved complete remission within 4 weeks. In the analysis of six patients who had taken oral prednisolone before starting HCQ, all were able to reduce the dose within 52 weeks without relapse. Particularly, 75% (3/4 cases) of patients with prednisolone dose of more than 5 mg/day could reduce their dose to less than 5 mg/day in combination with HCQ. For the safety concerns, two patients experienced grade 1 diarrhea during the 52-week observation period. However, neither serious adverse events nor adverse events requiring discontinuation of treatment occurred. The results of the present study suggest that HCQ may not only be highly effective as a single agent, but may also be useful as a steroid-sparing agent in refractory case requiring long-term steroid administration, making it a good treatment option for AESS.
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Affiliation(s)
- Hiroki Arakawa
- Department of Dermatology, Keio University School of Medicine, Tokyo, Japan
| | - Keiji Tanese
- Department of Dermatology, Keio University School of Medicine, Tokyo, Japan
| | - Ryo Tanaka
- Department of Dermatology, Keio University School of Medicine, Tokyo, Japan
| | - Kaori Murakami
- Department of Dermatology, Keio University School of Medicine, Tokyo, Japan
| | - Kazuyo Sujino
- Department of Dermatology, Keio University School of Medicine, Tokyo, Japan
| | - Julia Miyamoto
- Department of Dermatology, Keio University School of Medicine, Tokyo, Japan
| | - Masayuki Amagai
- Department of Dermatology, Keio University School of Medicine, Tokyo, Japan
| | - Akiko Tanikawa
- Department of Dermatology, Keio University School of Medicine, Tokyo, Japan
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8
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Negrini S, Emmi G, Greco M, Borro M, Sardanelli F, Murdaca G, Indiveri F, Puppo F. Sjögren's syndrome: a systemic autoimmune disease. Clin Exp Med 2021; 22:9-25. [PMID: 34100160 PMCID: PMC8863725 DOI: 10.1007/s10238-021-00728-6] [Citation(s) in RCA: 127] [Impact Index Per Article: 42.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 05/26/2021] [Indexed: 12/20/2022]
Abstract
Sjögren's syndrome is a chronic autoimmune disease characterized by ocular and oral dryness resulting from lacrimal and salivary gland dysfunction. Besides, a variety of systemic manifestations may occur, involving virtually any organ system. As a result, the disease is characterized by pleomorphic clinical manifestations whose characteristics and severity may vary greatly from one patient to another. Sjögren's syndrome can be defined as primary or secondary, depending on whether it occurs alone or in association with other systemic autoimmune diseases, respectively. The pathogenesis of Sjögren's syndrome is still elusive, nevertheless, different, not mutually exclusive, models involving genetic and environmental factors have been proposed to explain its development. Anyhow, the emergence of aberrant autoreactive B-lymphocytes, conducting to autoantibody production and immune complex formation, seems to be crucial in the development of the disease. The diagnosis of Sjögren's syndrome is based on characteristic clinical signs and symptoms, as well as on specific tests including salivary gland histopathology and autoantibodies. Recently, new classification criteria and disease activity scores have been developed primarily for research purposes and they can also be useful tools in everyday clinical practice. Treatment of Sjögren's syndrome ranges from local and symptomatic therapies aimed to control dryness to systemic medications, including disease-modifying agents and biological drugs. The objective of this review paper is to summarize the recent literature on Sjögren's syndrome, starting from its pathogenesis to current therapeutic options.
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Affiliation(s)
- Simone Negrini
- Department of Internal Medicine, Clinical Immunology and Translational Medicine Unit, University of Genoa and IRCCS Ospedale Policlinico San Martino, Viale Benedetto XV, 6, 16132, Genoa, Italy.
| | - Giacomo Emmi
- Department of Experimental and Clinical Medicine, University of Florence, 50134, Florence, Italy
| | - Monica Greco
- Department of Internal Medicine, University of Genoa, 16132, Genoa, Italy
| | - Matteo Borro
- Department of Internal Medicine, University of Genoa, 16132, Genoa, Italy
| | | | - Giuseppe Murdaca
- Department of Internal Medicine, University of Genoa, 16132, Genoa, Italy
| | - Francesco Indiveri
- Department of Internal Medicine, University of Genoa, 16132, Genoa, Italy
| | - Francesco Puppo
- Department of Internal Medicine, University of Genoa, 16132, Genoa, Italy
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9
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Orgeolet L, Foulquier N, Misery L, Redou P, Pers JO, Devauchelle-Pensec V, Saraux A. Can artificial intelligence replace manual search for systematic literature? Review on cutaneous manifestations in primary Sjögren’s syndrome. Rheumatology (Oxford) 2019; 59:811-819. [DOI: 10.1093/rheumatology/kez370] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 07/09/2019] [Indexed: 01/12/2023] Open
Abstract
Abstract
Objectives
Manual systematic literature reviews are becoming increasingly challenging due to the sharp rise in publications. The primary objective of this literature review was to compare manual and computer software using artificial intelligence retrieval of publications on the cutaneous manifestations of primary SS, but we also evaluated the prevalence of cutaneous manifestations in primary SS.
Methods
We compared manual searching and searching with the in-house computer software BIbliography BOT (BIBOT) designed for article retrieval and analysis. Both methods were used for a systematic literature review on a complex topic, i.e. the cutaneous manifestations of primary SS. Reproducibility was estimated by computing Cohen’s κ coefficients and was interpreted as follows: slight, 0–0.20; fair, 0.21–0.40; moderate, 0.41–0.60; substantial, 0.61–0.80; and almost perfect, 0.81–1.
Results
The manual search retrieved 855 articles and BIBOT 1042 articles. In all, 202 articles were then selected by applying exclusion criteria. Among them, 155 were retrieved by both methods, 33 by manual search only, and 14 by BIBOT only. Reliability (κ = 0.84) was almost perfect. Further selection was performed by reading the 202 articles. Cohort sizes and the nature and prevalence of cutaneous manifestations varied across publications. In all, we found 52 cutaneous manifestations reported in primary SS patients. The most described ones were cutaneous vasculitis (561 patients), xerosis (651 patients) and annular erythema (215 patients).
Conclusion
Among the final selection of 202 articles, 155/202 (77%) were found by the two methods but BIBOT was faster and automatically classified the articles in a chart. Combining the two methods retrieved the largest number of publications.
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Affiliation(s)
- Laure Orgeolet
- Dermatology Unit, UMR 1101, IBRBS, Université de Brest, Inserm, CHU
| | - Nathan Foulquier
- LATIM, Laboratoire de Traitement de l’Information Médicale, UMR 1101, IBRBS, Université de Brest, Inserm, CHU
| | - Laurent Misery
- Dermatology Unit, UMR 1101, IBRBS, Université de Brest, Inserm, CHU
| | - Pascal Redou
- LATIM, Laboratoire de Traitement de l’Information Médicale, UMR 1101, IBRBS, Université de Brest, Inserm, CHU
| | - Jacques-Olivier Pers
- UMR1227, Lymphocytes B et Autoimmunité, Université de Brest, Inserm, CHU Brest, LabEx IGO
| | - Valérie Devauchelle-Pensec
- UMR1227, Lymphocytes B et Autoimmunité, Université de Brest, Inserm, CHU Brest, LabEx IGO
- Rheumatology Unit, Centre National de Référence des Maladies Auto-Immunes Rares (CERAINO), CHU, Brest, France
| | - Alain Saraux
- UMR1227, Lymphocytes B et Autoimmunité, Université de Brest, Inserm, CHU Brest, LabEx IGO
- Rheumatology Unit, Centre National de Référence des Maladies Auto-Immunes Rares (CERAINO), CHU, Brest, France
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10
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Facial Plaque in a Woman With Sjogren Syndrome: Answer. Am J Dermatopathol 2018; 40:933-934. [PMID: 30475274 DOI: 10.1097/dad.0000000000001035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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11
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Jhorar P, Torre K, Lu J. Cutaneous features and diagnosis of primary Sjögren syndrome: An update and review. J Am Acad Dermatol 2018; 79:736-745. [DOI: 10.1016/j.jaad.2018.05.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Revised: 05/02/2018] [Accepted: 05/14/2018] [Indexed: 12/25/2022]
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12
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Paravar T. Less common rheumatologic disorders: Current concepts of skin and systemic manifestations. Clin Dermatol 2018; 36:525-532. [DOI: 10.1016/j.clindermatol.2018.04.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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13
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Gray A, Lockwood S, Mirrakhimov AE, Gelber AC, Manesh R. Near and Far. J Hosp Med 2018; 13:424-428. [PMID: 29261817 DOI: 10.12788/jhm.2893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Adam Gray
- Department of Medicine, University of Kentucky College of Medicine, Lexington, Kentucky, USA
- Department of Medicine, Lexington Veterans Affairs Medical Center, Lexington, Kentucky, USA
| | - Sean Lockwood
- Department of Medicine, University of Kentucky College of Medicine, Lexington, Kentucky, USA
- Department of Medicine, Lexington Veterans Affairs Medical Center, Lexington, Kentucky, USA
| | - Aibek E Mirrakhimov
- Department of Medicine, University of Kentucky College of Medicine, Lexington, Kentucky, USA
| | - Allan C Gelber
- Department of Medicine, Johns Hopkins Hospital and Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Reza Manesh
- Department of Medicine, Johns Hopkins Hospital and Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
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14
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Sumida T, Azuma N, Moriyama M, Takahashi H, Asashima H, Honda F, Abe S, Ono Y, Hirota T, Hirata S, Tanaka Y, Shimizu T, Nakamura H, Kawakami A, Sano H, Ogawa Y, Tsubota K, Ryo K, Saito I, Tanaka A, Nakamura S, Takamura E, Tanaka M, Suzuki K, Takeuchi T, Yamakawa N, Mimori T, Ohta A, Nishiyama S, Yoshihara T, Suzuki Y, Kawano M, Tomiita M, Tsuboi H. Clinical practice guideline for Sjögren's syndrome 2017. Mod Rheumatol 2018; 28:383-408. [PMID: 29409370 DOI: 10.1080/14397595.2018.1438093] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVES The objective of this study is to develop clinical practice guideline (CPG) for Sjögren's syndrome (SS) based on recently available clinical and therapeutic evidences. METHODS The CPG committee for SS was organized by the Research Team for Autoimmune Diseases, Research Program for Intractable Disease of the Ministry of Health, Labor and Welfare (MHLW), Japan. The committee completed a systematic review of evidences for several clinical questions and developed CPG for SS 2017 according to the procedure proposed by the Medical Information Network Distribution Service (Minds). The recommendations and their strength were checked by the modified Delphi method. The CPG for SS 2017 has been officially approved by both Japan College of Rheumatology and the Japanese Society for SS. RESULTS The CPG committee set 38 clinical questions for clinical symptoms, signs, treatment, and management of SS in pediatric, adult and pregnant patients, using the PICO (P: patients, problem, population, I: interventions, C: comparisons, controls, comparators, O: outcomes) format. A summary of evidence, development of recommendation, recommendation, and strength for these 38 clinical questions are presented in the CPG. CONCLUSION The CPG for SS 2017 should contribute to improvement and standardization of diagnosis and treatment of SS.
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Affiliation(s)
- Takayuki Sumida
- a Department of Internal Medicine , University of Tsukuba , Ibaraki , Japan.,b Clinical Practice Guideline Committee for Sjögren's Syndrome, The Research Team for Autoimmune Diseases, The Research Program for Intractable Disease of the Ministry of Health, Labor and Welfare (MHLW) , Tokyo , Japan
| | - Naoto Azuma
- b Clinical Practice Guideline Committee for Sjögren's Syndrome, The Research Team for Autoimmune Diseases, The Research Program for Intractable Disease of the Ministry of Health, Labor and Welfare (MHLW) , Tokyo , Japan.,c Division of Rheumatology, Department of Internal Medicine , Hyogo College of Medicine , Hyogo , Japan
| | - Masafumi Moriyama
- b Clinical Practice Guideline Committee for Sjögren's Syndrome, The Research Team for Autoimmune Diseases, The Research Program for Intractable Disease of the Ministry of Health, Labor and Welfare (MHLW) , Tokyo , Japan.,d Section of Oral and Maxillofacial Oncology, Division of Maxillofacial Diagnostic and Surgical Sciences , Kyushu University , Fukuoka , Japan
| | - Hiroyuki Takahashi
- a Department of Internal Medicine , University of Tsukuba , Ibaraki , Japan.,b Clinical Practice Guideline Committee for Sjögren's Syndrome, The Research Team for Autoimmune Diseases, The Research Program for Intractable Disease of the Ministry of Health, Labor and Welfare (MHLW) , Tokyo , Japan
| | - Hiromitsu Asashima
- a Department of Internal Medicine , University of Tsukuba , Ibaraki , Japan.,b Clinical Practice Guideline Committee for Sjögren's Syndrome, The Research Team for Autoimmune Diseases, The Research Program for Intractable Disease of the Ministry of Health, Labor and Welfare (MHLW) , Tokyo , Japan
| | - Fumika Honda
- a Department of Internal Medicine , University of Tsukuba , Ibaraki , Japan
| | - Saori Abe
- a Department of Internal Medicine , University of Tsukuba , Ibaraki , Japan
| | - Yuko Ono
- a Department of Internal Medicine , University of Tsukuba , Ibaraki , Japan.,d Section of Oral and Maxillofacial Oncology, Division of Maxillofacial Diagnostic and Surgical Sciences , Kyushu University , Fukuoka , Japan
| | - Tomoya Hirota
- a Department of Internal Medicine , University of Tsukuba , Ibaraki , Japan.,b Clinical Practice Guideline Committee for Sjögren's Syndrome, The Research Team for Autoimmune Diseases, The Research Program for Intractable Disease of the Ministry of Health, Labor and Welfare (MHLW) , Tokyo , Japan
| | - Shintaro Hirata
- b Clinical Practice Guideline Committee for Sjögren's Syndrome, The Research Team for Autoimmune Diseases, The Research Program for Intractable Disease of the Ministry of Health, Labor and Welfare (MHLW) , Tokyo , Japan.,e The First Department of Internal Medicine , School of Medicine, University of Occupational and Environmental Health, Japan , Fukuoka , Japan.,f Department of Clinical Immunology and Rheumatology , Hiroshima University Hospital , Hiroshima , Japan
| | - Yoshiya Tanaka
- b Clinical Practice Guideline Committee for Sjögren's Syndrome, The Research Team for Autoimmune Diseases, The Research Program for Intractable Disease of the Ministry of Health, Labor and Welfare (MHLW) , Tokyo , Japan.,e The First Department of Internal Medicine , School of Medicine, University of Occupational and Environmental Health, Japan , Fukuoka , Japan
| | - Toshimasa Shimizu
- b Clinical Practice Guideline Committee for Sjögren's Syndrome, The Research Team for Autoimmune Diseases, The Research Program for Intractable Disease of the Ministry of Health, Labor and Welfare (MHLW) , Tokyo , Japan.,g Unit of Translational Medicine, Department of Immunology and Rheumatology , Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan
| | - Hideki Nakamura
- b Clinical Practice Guideline Committee for Sjögren's Syndrome, The Research Team for Autoimmune Diseases, The Research Program for Intractable Disease of the Ministry of Health, Labor and Welfare (MHLW) , Tokyo , Japan.,g Unit of Translational Medicine, Department of Immunology and Rheumatology , Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan
| | - Atsushi Kawakami
- b Clinical Practice Guideline Committee for Sjögren's Syndrome, The Research Team for Autoimmune Diseases, The Research Program for Intractable Disease of the Ministry of Health, Labor and Welfare (MHLW) , Tokyo , Japan.,g Unit of Translational Medicine, Department of Immunology and Rheumatology , Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan
| | - Hajime Sano
- b Clinical Practice Guideline Committee for Sjögren's Syndrome, The Research Team for Autoimmune Diseases, The Research Program for Intractable Disease of the Ministry of Health, Labor and Welfare (MHLW) , Tokyo , Japan.,c Division of Rheumatology, Department of Internal Medicine , Hyogo College of Medicine , Hyogo , Japan
| | - Yoko Ogawa
- b Clinical Practice Guideline Committee for Sjögren's Syndrome, The Research Team for Autoimmune Diseases, The Research Program for Intractable Disease of the Ministry of Health, Labor and Welfare (MHLW) , Tokyo , Japan.,h Department of Ophthalmology , School of Medicine, Keio University , Tokyo , Japan
| | - Kazuo Tsubota
- b Clinical Practice Guideline Committee for Sjögren's Syndrome, The Research Team for Autoimmune Diseases, The Research Program for Intractable Disease of the Ministry of Health, Labor and Welfare (MHLW) , Tokyo , Japan.,h Department of Ophthalmology , School of Medicine, Keio University , Tokyo , Japan
| | - Koufuchi Ryo
- b Clinical Practice Guideline Committee for Sjögren's Syndrome, The Research Team for Autoimmune Diseases, The Research Program for Intractable Disease of the Ministry of Health, Labor and Welfare (MHLW) , Tokyo , Japan.,i Department of Pathology , Tsurumi University School of Dental Medicine , Kanagawa , Japan
| | - Ichiro Saito
- b Clinical Practice Guideline Committee for Sjögren's Syndrome, The Research Team for Autoimmune Diseases, The Research Program for Intractable Disease of the Ministry of Health, Labor and Welfare (MHLW) , Tokyo , Japan.,i Department of Pathology , Tsurumi University School of Dental Medicine , Kanagawa , Japan
| | - Akihiko Tanaka
- b Clinical Practice Guideline Committee for Sjögren's Syndrome, The Research Team for Autoimmune Diseases, The Research Program for Intractable Disease of the Ministry of Health, Labor and Welfare (MHLW) , Tokyo , Japan.,d Section of Oral and Maxillofacial Oncology, Division of Maxillofacial Diagnostic and Surgical Sciences , Kyushu University , Fukuoka , Japan
| | - Seiji Nakamura
- b Clinical Practice Guideline Committee for Sjögren's Syndrome, The Research Team for Autoimmune Diseases, The Research Program for Intractable Disease of the Ministry of Health, Labor and Welfare (MHLW) , Tokyo , Japan.,d Section of Oral and Maxillofacial Oncology, Division of Maxillofacial Diagnostic and Surgical Sciences , Kyushu University , Fukuoka , Japan
| | - Etsuko Takamura
- b Clinical Practice Guideline Committee for Sjögren's Syndrome, The Research Team for Autoimmune Diseases, The Research Program for Intractable Disease of the Ministry of Health, Labor and Welfare (MHLW) , Tokyo , Japan.,j Department of Ophthalmology , Tokyo Women's Medical University, School of Medicine , Tokyo , Japan
| | - Masao Tanaka
- b Clinical Practice Guideline Committee for Sjögren's Syndrome, The Research Team for Autoimmune Diseases, The Research Program for Intractable Disease of the Ministry of Health, Labor and Welfare (MHLW) , Tokyo , Japan.,k Department of Advanced Medicine for Rheumatic Diseases , Kyoto University Graduate School of Medicine , Kyoto , Japan
| | - Katsuya Suzuki
- b Clinical Practice Guideline Committee for Sjögren's Syndrome, The Research Team for Autoimmune Diseases, The Research Program for Intractable Disease of the Ministry of Health, Labor and Welfare (MHLW) , Tokyo , Japan.,l Division of Rheumatology, Department of Internal Medicine , School of Medicine, Keio University , Tokyo , Japan
| | - Tsutomu Takeuchi
- b Clinical Practice Guideline Committee for Sjögren's Syndrome, The Research Team for Autoimmune Diseases, The Research Program for Intractable Disease of the Ministry of Health, Labor and Welfare (MHLW) , Tokyo , Japan.,l Division of Rheumatology, Department of Internal Medicine , School of Medicine, Keio University , Tokyo , Japan
| | - Noriyuki Yamakawa
- b Clinical Practice Guideline Committee for Sjögren's Syndrome, The Research Team for Autoimmune Diseases, The Research Program for Intractable Disease of the Ministry of Health, Labor and Welfare (MHLW) , Tokyo , Japan.,m Department of Rheumatology and Clinical Immunology , Kyoto University Graduate School of Medicine , Kyoto , Japan.,n Department of Rheumatology , Kyoto-Katsura Hospital , Kyoto , Japan
| | - Tsuneyo Mimori
- b Clinical Practice Guideline Committee for Sjögren's Syndrome, The Research Team for Autoimmune Diseases, The Research Program for Intractable Disease of the Ministry of Health, Labor and Welfare (MHLW) , Tokyo , Japan.,m Department of Rheumatology and Clinical Immunology , Kyoto University Graduate School of Medicine , Kyoto , Japan
| | - Akiko Ohta
- b Clinical Practice Guideline Committee for Sjögren's Syndrome, The Research Team for Autoimmune Diseases, The Research Program for Intractable Disease of the Ministry of Health, Labor and Welfare (MHLW) , Tokyo , Japan.,o Division of Public Health, Department of Social Medicine , Saitama Medical University , Saitama , Japan
| | - Susumu Nishiyama
- b Clinical Practice Guideline Committee for Sjögren's Syndrome, The Research Team for Autoimmune Diseases, The Research Program for Intractable Disease of the Ministry of Health, Labor and Welfare (MHLW) , Tokyo , Japan.,p Kurashiki Medical Center , Okayama , Japan
| | - Toshio Yoshihara
- b Clinical Practice Guideline Committee for Sjögren's Syndrome, The Research Team for Autoimmune Diseases, The Research Program for Intractable Disease of the Ministry of Health, Labor and Welfare (MHLW) , Tokyo , Japan.,q Department of Otorhinolaryngology , Tokyo Women's Medical University , Tokyo , Japan
| | - Yasunori Suzuki
- b Clinical Practice Guideline Committee for Sjögren's Syndrome, The Research Team for Autoimmune Diseases, The Research Program for Intractable Disease of the Ministry of Health, Labor and Welfare (MHLW) , Tokyo , Japan.,r Division of Rheumatology, Department of Cardiovascular and Internal Medicine , Kanazawa University Graduate School of Medicine , Ishikawa , Japan
| | - Mitsuhiro Kawano
- b Clinical Practice Guideline Committee for Sjögren's Syndrome, The Research Team for Autoimmune Diseases, The Research Program for Intractable Disease of the Ministry of Health, Labor and Welfare (MHLW) , Tokyo , Japan.,r Division of Rheumatology, Department of Cardiovascular and Internal Medicine , Kanazawa University Graduate School of Medicine , Ishikawa , Japan
| | - Minako Tomiita
- b Clinical Practice Guideline Committee for Sjögren's Syndrome, The Research Team for Autoimmune Diseases, The Research Program for Intractable Disease of the Ministry of Health, Labor and Welfare (MHLW) , Tokyo , Japan.,s Department of Allergy and Rheumatology , Chiba Children's Hospital , Chiba , Japan
| | - Hiroto Tsuboi
- a Department of Internal Medicine , University of Tsukuba , Ibaraki , Japan.,b Clinical Practice Guideline Committee for Sjögren's Syndrome, The Research Team for Autoimmune Diseases, The Research Program for Intractable Disease of the Ministry of Health, Labor and Welfare (MHLW) , Tokyo , Japan
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15
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Affiliation(s)
- Pulukool Sandhya
- Department of Clinical Immunology and Rheumatology; Christian Medical College and Hospital; Vellore Tamil Nadu India
| | - Debashish Danda
- Department of Clinical Immunology and Rheumatology; Christian Medical College and Hospital; Vellore Tamil Nadu India
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16
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Kabuto M, Fujimoto N, Hamaguchi Y, Tanaka T. Anti-signal recognition particle antibody-positive polymyositis in a patient with Sjögren's syndrome showing various types of annular erythema: Positive correlation between the activities of annular erythema and myositis. J Dermatol 2016; 43:958-61. [PMID: 26972113 DOI: 10.1111/1346-8138.13344] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Accepted: 01/24/2016] [Indexed: 11/27/2022]
Abstract
Annular erythema with Sjögren's syndrome (AESS) is occasionally found, especially in Asian patients, which is classified into three types. We present a case of Sjögren's syndrome showing various types of AESS with anti-signal recognition particle antibody-positive polymyositis. We successfully treated the eruption and myositis with a low dose of prednisolone. Every onset of annular erythema coincided with elevation of serum creatine kinase levels, which suggests the correlation between the activities of annular erythema and polymyositis.
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Affiliation(s)
- Miho Kabuto
- Department of Dermatology, Shiga University of Medical Science, Otsu, Japan
| | - Noriki Fujimoto
- Department of Dermatology, Shiga University of Medical Science, Otsu, Japan
| | - Yasuhito Hamaguchi
- Department of Dermatology, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan
| | - Toshihiro Tanaka
- Department of Dermatology, Shiga University of Medical Science, Otsu, Japan
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17
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Takeo N, Sakai T, Saito-Shono T, Ishikawa K, Hatano Y, Katagiri K, Takahashi Y, Kawano K, Kimoto K, Kubota T, Eshima N, Kojima H, Fujiwara S. Three cases of pigmented cosmetic dermatitis-like eruptions associated with primary Sjögren's syndrome or anti-SSA antibody. J Dermatol 2016; 43:947-50. [PMID: 26892480 DOI: 10.1111/1346-8138.13300] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2015] [Accepted: 12/15/2015] [Indexed: 11/29/2022]
Abstract
Pigmented cosmetic dermatitis-like (Riehl's melanosis-like) pigmentation was reported in three of 27 patients with primary Sjögren's syndrome. But case reports of such eruptions are rare. We describe three cases of such eruptions associated with primary Sjögren's syndrome or anti-SSA antibody and possible associations with specific types of human leukocyte antigen (HLA) and infiltrating lymphocytes. These middle-aged Japanese women had reticular facial pigmentation and histopathological examination revealed interface dermatitis, melanophages, and dense lymphocytic infiltration around hair follicles and sweat ducts. HLA typing revealed common antigenic equivalents or genetic typing of HLA-A2, DR52, DPA1(02:02) and DPB1(05:01). Immunohistochemical staining revealed major subsets of T cells to be CD8 and CD45RO. Some Foxp3- and few IL17-positive cells were found in strong contrast to the major CD4 subset of infiltrated T cells in annular erythema associated with Sjögren's syndrome. Apparently, our patients' pigmentation represented a specific etiology associated with primary Sjögren's syndrome or anti-SSA antibody.
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Affiliation(s)
- Naoko Takeo
- Department of Dermatology, Oita University, Kyoto, Japan
| | - Takashi Sakai
- Department of Dermatology, Oita University, Kyoto, Japan
| | | | | | - Yutaka Hatano
- Department of Dermatology, Oita University, Kyoto, Japan
| | | | - Yoshihiro Takahashi
- Department of Oral and Maxillo-Facial Surgery, Oita University, Kyoto, Japan
| | - Kenji Kawano
- Department of Oral and Maxillo-Facial Surgery, Oita University, Kyoto, Japan
| | - Kenichi Kimoto
- Department of Ophthalmology, Oita University, Kyoto, Japan
| | | | - Nobuoki Eshima
- Department of Biostatistics, Faculty of Medicine, Oita University, Kyoto, Japan
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18
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Kabuto M, Fujimoto N, Tanaka T. Two cases of annular erythema without bullous lesions by autoimmune blistering diseases. Mod Rheumatol 2015; 28:200-202. [PMID: 26382039 DOI: 10.3109/14397595.2015.1081721] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Although annular erythema is usually observed as one of the cutaneous manifestations of Sjögren's syndrome or subacute cutaneous lupus erythematosus, autoimmune blistering diseases also present with annular erythema. However, bullous lesions are not always found, and there is a rare type without bullous lesions. We present two cases of autoimmune blistering diseases showing annular erythema without bullous lesions. It is important to perform direct or indirect immunofluorescence examination when we encounter multiple annular erythema.
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Affiliation(s)
- Miho Kabuto
- a Department of Dermatology , Shiga University of Medical Science , Setatsukinowa , Otsu , Shiga , Japan
| | - Noriki Fujimoto
- a Department of Dermatology , Shiga University of Medical Science , Setatsukinowa , Otsu , Shiga , Japan
| | - Toshihiro Tanaka
- a Department of Dermatology , Shiga University of Medical Science , Setatsukinowa , Otsu , Shiga , Japan
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19
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Ramos-Casals M, Brito-Zerón P, Seror R, Bootsma H, Bowman SJ, Dörner T, Gottenberg JE, Mariette X, Theander E, Bombardieri S, De Vita S, Mandl T, Ng WF, Kruize A, Tzioufas A, Vitali C. Characterization of systemic disease in primary Sjögren's syndrome: EULAR-SS Task Force recommendations for articular, cutaneous, pulmonary and renal involvements. Rheumatology (Oxford) 2015; 54:2230-8. [PMID: 26231345 DOI: 10.1093/rheumatology/kev200] [Citation(s) in RCA: 165] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE To reach a European consensus on the definition and characterization of the main organ-specific extraglandular manifestations in primary SS. METHODS The EULAR-SS Task Force Group steering committee agreed to approach SS-related systemic involvement according to the EULAR SS Disease Activity Index (ESSDAI) classification and proposed the preparation of four separate manuscripts: articular, cutaneous, pulmonary and renal ESSDAI involvement; muscular, peripheral nervous system, CNS and haematological ESSDAI involvement; organs not included in the ESSDAI classification; and lymphoproliferative disease. Currently available evidence was obtained by a systematic literature review focused on SS-related systemic features. RESULTS The following information was summarized for articular, cutaneous, pulmonary and renal involvement: a clear, consensual definition of the clinical feature, a brief epidemiological description including an estimate of the prevalence reported in the main clinical series and a brief list of the key clinical and diagnostic features that could help physicians clearly identify these features. Unfortunately we found that the body of evidence relied predominantly on information retrieved from individual cases, and the scientific information provided was heterogeneous. The analysis of types of involvement was biased due to the unbalanced reporting of severe cases over non-severe cases, although the main sources of bias were the heterogeneous definitions of organ involvement (or even the lack of definition in some studies) and the heterogeneous diagnostic approach used in studies to investigate involvment of each organ. CONCLUSION The proposals included in this article are a first step to developing an optimal diagnostic approach to systemic involvement in primary SS and may pave the way for further development of evidence-based diagnostic and therapeutic guidelines.
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Affiliation(s)
- Manuel Ramos-Casals
- Sjögren Syndrome Research Group (AGAUR), Laboratory of Autoimmune Diseases Josep Font, IDIBAPS, Department of Autoimmune Diseases, ICMiD, Hospital Clínic, Barcelona, Spain,
| | - Pilar Brito-Zerón
- Sjögren Syndrome Research Group (AGAUR), Laboratory of Autoimmune Diseases Josep Font, IDIBAPS, Department of Autoimmune Diseases, ICMiD, Hospital Clínic, Barcelona, Spain
| | - Raphaèle Seror
- Department of Rheumatology, Hôpitaux Universitaires Paris-Sud, Assistance Publique-Hopitaux de Paris, Le Kremlin Bicêtre, Université Paris-Sud 11, UMR 1184, Le Kremlin Bicêtre, Paris, France
| | - Hendrika Bootsma
- Department of Rheumatology and Clinical Immunology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Simon J Bowman
- Rheumatology Department, University Hospital Birmingham NHS Foundation Trust, Birmingham, UK
| | - Thomas Dörner
- Rheumatology Department, Charité, University Hospital, Berlin, Germany
| | - Jacques-Eric Gottenberg
- Department of Rheumatology, EA 4438, Strasbourg University Hospital, Université de Strasbourg, Strasbourg, France
| | - Xavier Mariette
- Department of Rheumatology, Hôpitaux Universitaires Paris-Sud, Assistance Publique-Hopitaux de Paris, Le Kremlin Bicêtre, Université Paris-Sud 11, UMR 1184, Le Kremlin Bicêtre, Paris, France
| | - Elke Theander
- Department of Rheumatology, Skane University Hospital Malmö, Lund University, Sweden
| | | | - Salvatore De Vita
- Clinic of Rheumatology, Department of Medical and Biological Sciences, University Hospital Santa Maria della Misericordia, Udine, Italy
| | - Thomas Mandl
- Department of Rheumatology, Skane University Hospital Malmö, Lund University, Sweden
| | - Wan-Fai Ng
- Musculoskeletal Research Group, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Aike Kruize
- Department of Rheumatology and Clinical Immunology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Athanasios Tzioufas
- Department of Pathophysiology, School of Medicine, University of Athens, Greece and
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20
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Itoi S, Tanemura A, Tani M, Kitaba S, Terao M, Murota H, Oiso N, Katayama I. Immunohistochemical Analysis of Interleukin-17 Producing T Helper Cells and Regulatory T Cells Infiltration in Annular Erythema Associated with Sjögren's Syndrome. Ann Dermatol 2014; 26:203-8. [PMID: 24882975 PMCID: PMC4037673 DOI: 10.5021/ad.2014.26.2.203] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2012] [Revised: 03/11/2013] [Accepted: 04/22/2013] [Indexed: 11/22/2022] Open
Abstract
Background Peculiar erythema known as annular erythema associated with Sjögren's syndrome (AESS) can be differentiated from autoimmune annular erythema and subacute cutaneous lupus erythematosus, both clinically and histologically. However, there are no detailed investigations on immune competent cells infiltration. Objective Preferential infiltration of interleukin-17-producing T helper (Th17) cells and regulatory T (Treg) cells into the labial salivary gland is reported to play a role in maintaining mucoepithelitis in patients with Sjögren's syndrome. In this study, we evaluated Th17 and Treg cell infiltration into the lesional skin of AESS. Methods We analyzed the numbers and infiltration patterns of Th17 and FoxP3 (+) Treg cells in seven cases of AESS using immunohistochemistry. Seven patients with systemic lupus erythematosus (SLE), atopic dermatitis (AD) and psoriasis vulgaris (PV), which are representatives of Th17 cell-involved skin disorders, were enrolled as disease controls. Results Periappendageal and epidermal changes, such as follicular plugging and liquefaction, were evident in the annular erythema of SLE, not AESS, tissue samples. In AESS tissue samples, dense perivascular and periappendageal infiltration of lymph cells was observed in the middle-to-deep dermis, as previously described, in contrast to the superficial infiltration pattern observed in both AD and PV samples. While the total number of infiltrated lymphocytes was similar between AESS and SLE tissue samples, Th17 cells were found to be preferentially infiltrated in the middle-to-deep dermis in AESS samples. Conclusion These results suggest that an increased number and distribution of infiltration of Th17 cells is a preferential feature of AESS, rather than a characteristic feature of annular erythema of SLE.
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Affiliation(s)
- Saori Itoi
- Department of Dermatology Integrated Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Atsushi Tanemura
- Department of Dermatology Integrated Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Mamori Tani
- Department of Dermatology Integrated Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Shun Kitaba
- Department of Dermatology Integrated Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Mika Terao
- Department of Dermatology Integrated Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Hiroyuki Murota
- Department of Dermatology Integrated Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Naoki Oiso
- Department of Dermatology, Kinki University Faculty of Medicine, Osaka, Japan
| | - Ichiro Katayama
- Department of Dermatology Integrated Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
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21
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Brito-Zerón P, Retamozo S, Akasbi M, Gandía M, Perez-De-Lis M, Soto-Cardenas MJ, Diaz-Lagares C, Kostov B, Bove A, Bosch X, Perez-Alvarez R, Siso A, Ramos-Casals M. Annular erythema in primary Sjögren’s syndrome: description of 43 non-Asian cases. Lupus 2013; 23:166-75. [DOI: 10.1177/0961203313515764] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Objective The objective of this paper is to evaluate the prevalence and characterize the main epidemiological, clinical and immunological features of annular erythema (AE) in non-Asian patients with primary Sjögren’s syndrome (SS). Methods We carried out a retrospective study searching for AE in 377 Spanish patients with primary SS fulfilling the 2002 American-European criteria. In addition, we searched PubMed (1994–2012) using the MeSH terms “annular erythema” and “primary Sjögren’s syndrome” for additional cases. All cases with AE reported in patients with SS associated with systemic lupus erythematosus were excluded. Results In our Spanish cohort, we found 35 (9%) patients diagnosed with AE. All were white females, with a mean age of 47 years at diagnosis of AE. AE preceded diagnosis of SS in 27 (77%) patients. Cutaneous AE lesions involved principally the face and upper extremities. All patients reported photosensitivity, with cutaneous flares being reported during the warmest months in 93% of patients. Immunological markers consisted of anti-Ro/La antibodies in 31 (89%) patients. In the literature search, we identified eight additional non-Asian patients with primary SS diagnosed with AE. In comparison with 52 Asian patients, the 43 non-Asian patients with AE related to primary SS were more frequently women (100% vs 78%, p = 0.008), and cutaneous lesions were less frequently reported in the face (55% vs 81%, p = 0.045) and more frequently in the neck (40% vs 14%, p = 0.041). Immunologically, non-Asian patients had a lower frequency of anti-Ro antibodies and a higher frequency of negative Ro/La antibodies, although the differences were not statistically significant. Conclusion AE is not an exclusive cutaneous feature of Asian patients with primary SS. In addition to the characteristic cutaneous expression, AE has a very specific clinical and immunological profile: often presenting before the fulfillment of SS criteria, overwhelmingly associated with anti-Ro antibodies but weakly associated with other immunological markers and the main systemic SS-related features.
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Affiliation(s)
- P Brito-Zerón
- Sjögren Syndrome Research Group (AGAUR), Laboratory of Autoimmune Diseases Josep Font-CELLEX, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Department of Autoimmune Diseases
| | - S Retamozo
- Sjögren Syndrome Research Group (AGAUR), Laboratory of Autoimmune Diseases Josep Font-CELLEX, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Department of Autoimmune Diseases
| | - M Akasbi
- Sjögren Syndrome Research Group (AGAUR), Laboratory of Autoimmune Diseases Josep Font-CELLEX, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Department of Autoimmune Diseases
- Department of Internal Medicine, Hospital Infanta Leonor, Spain
| | - M Gandía
- Department of Internal Medicine, University of Cadiz, Hospital Puerta del Mar, Spain
| | - M Perez-De-Lis
- Department of Internal Medicine, Hospital do Meixoeiro, Spain
| | - M-J Soto-Cardenas
- Department of Internal Medicine, University of Cadiz, Hospital Puerta del Mar, Spain
| | - C Diaz-Lagares
- Sjögren Syndrome Research Group (AGAUR), Laboratory of Autoimmune Diseases Josep Font-CELLEX, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Department of Autoimmune Diseases
| | - B Kostov
- Primary Care Research Group, IDIBAPS, Centre d’Assistència Primària ABS Les Corts, GESCLINIC, Spain
| | - A Bove
- Sjögren Syndrome Research Group (AGAUR), Laboratory of Autoimmune Diseases Josep Font-CELLEX, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Department of Autoimmune Diseases
| | - X Bosch
- Department of Internal Medicine, ICMiD, Spain
| | - R Perez-Alvarez
- Department of Internal Medicine, Hospital do Meixoeiro, Spain
| | - A Siso
- Primary Care Research Group, IDIBAPS, Centre d’Assistència Primària ABS Les Corts, GESCLINIC, Spain
| | - M Ramos-Casals
- Sjögren Syndrome Research Group (AGAUR), Laboratory of Autoimmune Diseases Josep Font-CELLEX, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Department of Autoimmune Diseases
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22
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Bernacchi E, Neri R, Caproni M, Loggini B, Fabbri P, Bombardieri S. Annular subacute cutaneous lupus erythematosus lesions and polymyositis onset in a patient with primary Sjögren's syndrome: how should this unusual association be classified? Lupus 2013; 22:312-5. [DOI: 10.1177/0961203312474703] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Classification of the wide variety of autoimmune diseases that can occur before or after the onset of Sjögren’s syndrome (SS) is currently debated within the conventional SS criteria or as primary SS ( pSS) developing autoimmune disease or as ‘associated-overlap’ with other systemic autoimmune diseases. There is also debate on whether or not to consider annular polycyclic subacute cutaneous lupus erythematosus (SCLE) and annular erythema associated with Sjögren's syndrome (AESS) as a spectrum linked to Ro-SSA and/or La-SSB auto-antibodies (SSA/SSB auto-ab). We present the case of a 55-year-old female patient, with pSS positive for SSA and SSB auto-ab, who developed chronic relapsing polymyositis and atypical annular non-polycyclic SCLE lesions resembling AESS, which seemed to suggest a common spectrum. While a chronic-progressive polymyositis may be generally accepted as a relatively rare myositis complicating pSS, interpretation of annular lesions of non-systemic SCLE in SS patients might actually be underestimated as pSS skin manifestation likely related to SSA/SSB auto-ab.
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Affiliation(s)
- E Bernacchi
- Dermatologic Clinic, University of Florence – Italian Group of Cutaneous Immunopathology, Italy
- UO Rheumatology, University of Pisa, Italy
| | - R Neri
- UO Rheumatology, University of Pisa, Italy
| | - M Caproni
- Dermatologic Clinic, University of Florence – Italian Group of Cutaneous Immunopathology, Italy
| | - B Loggini
- Patological Anatomy Institute, University of Pisa, Italy
| | - P Fabbri
- Dermatologic Clinic, University of Florence – Italian Group of Cutaneous Immunopathology, Italy
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