The prevalence of antinuclear antibodies in patients with apparent polymorphic light eruption

Polymorphic light eruption (PLE) is a very common photosensitive disorder, the most important differential diagnosis of which is lupus erythematosus (LE). One-hundred and forty-two patients with PLE were screened for circulating antinuclear (ANA), Ro and La antibodies over a 2-year period. Results were negative in 66 patients. Sixty-two patients had low-titre ANA of various patterns, ranging from trace to 1/80 without evidence of LE although one later developed subacute cutaneous LE. Fourteen had more significant findings, six with ANA ranging from 1/160 to 1/1280 but no anti-Ro antibodies, four with ANA ranging from 1/160 to 1/1280 and also with anti-Ro antibodies and four patients with anti-Ro antibodies but low-titre ANA, one of whom later developed discoid LE. Three of these 14 patients fulfilled the American Rheumatism Association criteria for the diagnosis of systemic LE, but it was not certain in any of the patients whether the PLE-like rash represented cutaneous LE or coincidental PLE. However the overall 10% incidence of definite or possible LE in patients with suspected PLE suggests that all PLE patients should be screened for LE.     

Serologic studies in patients with lupus erythematosus and psoriasis

We present four patients with coexistent lupus erythematosus (LE) and psoriasis. This is an unusual combination. All four patients had antibodies to Ro, which were absent in twenty-four control psoriatics. Antibodies to Ro occur in only 25% to 30% of unselected SLE patients, but occur in approximately 60% of "antinuclear antibody (ANA)-negative" LE patients, many of whom are highly photosensitive. The increased frequency of anti-Ro in our patients suggests that this may be a specific serologic marker for the LE/psoriasis overlap. Also, since anti-Ro correlates with photosensitivity, LE/psoriasis overlap patients may be at increased risk for photosensitivity, which occurred in two of our patients, one of whom developed severe systemic disease following ultraviolet (UVB) phototherapy. Screening for anti-Ro antibodies may be appropriate in psoriatics prior to UVB phototherapy.     

Familial clustering of polymorphic light eruption in relatives of patients with lupus erythematosus: evidence of a shared pathogenesis

BACKGROUND: Abnormal photosensitivity is a common feature of many forms of lupus erythematosus (LE). OBJECTIVES: To examine the role of polymorphic light eruption (PLE) as a possible predisposing factor for cutaneous forms of LE. METHODS: Eighty-five patients with well-characterized subacute cutaneous LE (SCLE) and discoid LE (DLE) were recruited from outpatient clinics, and the prevalence of PLE determined by detailed interview and clinical examination. RESULTS: Symptoms consistent with PLE were reported in 61% and 55% of SCLE and DLE patients, respectively; this was significantly higher than the overall population prevalence of 13.6% (P < 0.001), giving a relative risk (RR) for PLE in SCLE patients of 3.37 (95% confidence interval, CI 2.46--4.28) and DLE patients of 3.11 (95% CI 2.31--3.91). PLE developed before the onset of LE in 61% of cases (median interval 12 years, range 1--40), concomitantly in 24%, and subsequently in a further 15% (median interval 3.5 years, range 1--25). To delineate the relationship between PLE and LE further, the prevalence of PLE was determined in 103 otherwise unaffected first-degree relatives of SCLE and DLE probands; we had previously demonstrated clustering of PLE in families, reflecting a strong genetic component. We found a significantly higher PLE prevalence in relatives of the LE probands than in the general population (P < 0.001), giving an RR for PLE of 2.29 (95% CI 1.55--3.03) and 2.61 (95% CI 1.32--3.89) for female and male relatives, respectively. CONCLUSIONS: The high prevalence of PLE in LE patients, together with clustering of PLE among first-degree relatives of SCLE and DLE probands, suggests that there may be a shared pathogenetic basis for PLE and cutaneous LE. We propose that predisposition to PLE may contribute to the LE phenotype in otherwise susceptible individuals.     

Lupus erythematosus of the skin. An analysis of 97 patients

In this retrospective study, the data of 97 patients with lupus erythematosus (LE) were evaluated according to clinical and laboratory criteria. 30 patients had localized chronic discoid LE (CDLE); 44 patients showed disseminated LE lesions either of the chronic discoid or the subacute cutaneous (SCLE) type; and 23 patients had systemic LE (SLE). The mean age ranged between 21 and 50 years. The male/female ratio was 1:3 in localized LE, 1:13 in disseminated LE with general symptoms, and 1:10 in SLE. Localized LE did not, as a rule, show any general symptoms. On the other hand, 14/44 patients (= 30%) with disseminated LE revealed general symptoms such as BSR elevation, arthralgia, anemia, and leukopenia. In addition, 4/44 patients (= 9%) with disseminated skin lesions showed various extracutaneous manifestations: nephritis (2), pericarditis (2), pleuritis (2), polyarthritis (1). Arthropathy was the major clinical manifestation in SLE (18/23 patients). Immunological parameters were usually negative in localized chronic discoid LE. 7/23 patients (= 30%) with disseminated LE had elevated ANA titers; 4/26 patients (= 15%) showed increased DNA binding capacity. In 57% of the patients with disseminated LE associated with general clinical symptoms, in contrast, we found elevated ANA titers; 71 of them revealed increased DNA binding capacity. Our findings suggest that disseminated LE, especially the SCLE type, may be regarded as variant of LE which tends to transition into SLE. Moreover, ANA titers may serve as a screening method; the detection of circulating DNA antibodies, however, is considered a rather specific parameter with regard to the diagnosis of systemic manifestation.     

Clinicopathological evaluation of in vivo epidermal nuclear fluorescence

Background.  Nuclear fluorescence in keratinocytes is an occasional phenomenon, often present in autoimmune diseases, especially in connective-tissue disease (CTD); however, its clinical significance remains unclear.
Aim.  To investigate the profile of patients with positive nuclear staining on direct immunofluorescence (DIF) of skin samples.
Methods.  A retrospective analysis of 28 patient records from our immunodermatology laboratory was performed between May 2003 and June 2006. Inclusion criteria were the presence of autoantibodies (IgG, IgA or IgM) or complement (C3) binding keratinocyte nuclei on DIF.
Results.  The most prevalent diseases related to the nuclear keratinocyte DIF staining were systemic lupus erythematosus ( n  = 9), mixed CTD ( n  = 3), overlap syndrome ( n  = 3), Sjögren's syndrome ( n  = 1), and CREST (calcinosis, Raynaud's phenomenon, oesophageal dysmotility, sclerodactyly and telangiectasia) syndrome ( n  = 1). Serum antinuclear antibody (ANA) was positive in 20 of 28 patients, with titres varying from 1 : 160 to 1 : 1280. Of the 20 patients with positive anti-nuclear antibodies (ANA), 17 were positive for anti-extractable nuclear antigen antibodies, 12 had anti-SSA/Ro, 11 had anti-SSB/La and 8 had anti-ribonucleoprotein. Eight patients were negative for ANA. Positive predictive value of in vivo ANA for systemic CTDs was 75%.
Conclusion.  The present data suggest that in vivo ANA evaluation is an additional and feasible auxiliary tool for diagnosing CTDs.     

Photosensitivity in lupus erythematosus, UV photoprovocation results compared with history of photosensitivity and clinical findings

Photosensitivity, one of the presenting symptoms in lupus erythematosus (LE), is still poorly defined and varying prevalence figures have been reported. The possibility of a coexisting photodermatosis, especially polymorphous light eruption (PLE), has often not been taken into account. We report the results of ultraviolet A (UVA) and B (UVB) photoprovocation tests in 67 clinically photosensitive patients who had confirmed discoid LE (DLE), systemic LE (SLE) or subacute cutaneous LE (SCLE). The results are compared with a detailed history of photosensitivity and with clinical and serological findings. A pathological photoprovocation reaction, graded as weak, moderate or strong, was induced with either UVA or UVB in 69% of patients with LE, in 100% of those with SCLE, in 70% of those with SLE and in 64% of those with DLE, but in none of 14 controls. Only 16% of the pathological reactions were strong and long-lasting, resembling LE lesions, while 48% were moderate or weak and transient, clinically like PLE. Fifty-three per cent of the provocation reactions which were biopsied showed a PLE-like histology or a non-specific inflammatory reaction, and most of them were clinically moderate or weak reactions of short duration. In the remaining, mostly clinically strong or long-lasting reactions, the histology was consistent with LE. A history of sunlight sensitivity did not predict a pathological photoprovocation result but a positive association between the presence of SSA/Ro or SSB/La antibodies and a pathological photoprovocation reaction was found. We have shown that PLE coexists with LE and that both PLE- and LE-like lesions can be induced with UV radiation in LE patients.     

A prospective immunofluorescence study of immune deposits in the skin of primary Sj?gren's syndrome

There are conflicting opinions concerning the epidermal immunofluorescence pattern in primary Sj?gren's syndrome. In a prospective study of 12 patients we found a characteristic pattern of epidermal nuclear/cytoplasmic IgG deposits in 8 (67%). This pattern was associated with the presence of antibodies against SSA/Ro and SSB/La in the serum and was also found in 2 out of 5 LE patients with monospecific antibodies against SSA/Ro. There is a resemblance to the pattern of dust-like particles described in the diseased skin of patients with subacute cutaneous LE. In one patient with primary Sj?gren's syndrome, IgG deposits were confined to epidermal cell nuclei (in vivo ANA). Instead of antibodies against SSA/Ro or SSB/La, this particular patient had nRNP-antibodies. From this study, we conclude that the epidermal IgG deposits in primary Sj?gren's syndrome may represent antibody binding to the sites within epidermal cells where the respective antigens are located.     

Unilateral nail dystrophy after C4 complete spinal cord injury

Summary Fifty-five patients with biopsy-proven cutaneous lupus erythematosus (LE) were identified in whom a prospective and retrospective review of the clinical and laboratory data allowed subclassification into systemic (SLE). subacute (SCLE). or discold (DLE) variants. In addition to conventional direct immunofluorescence. an indirect immunolluorescent technique. using a monoclonal antibody, was employed to assess deposition of the membranolytic attack complex (C_5b?9) in skin lesions. Deposition of C_5b?9 within the epidermis correlated with a diagnosis of SCLE with or without antibodies to Ro and was seen in SLE patients with antibodies to extractable nuclear antigens Ro. La, Sm. and RNP. and in DLE patients with positive antinuclear antibodies and/or extracutaneous manifestations. In the SLE group, vascular C_5b?9 deposition was present in six patients. Of these, tour had circulating lupus anticoagulant, one had lymphocytic vasculitis, and two had antibodies to Ro. In two patients with SLE there was keratinocyte decoration for immunoglobulin G but not for C_5b?9, in the absence of seropositivity for antibodies to Ro. La. Sm. and ribonucleoprotein (RNP). The immunohistological examination of skin lesions using a monoclonal antibody to C_5b?9 is a valuable adjunct in the subclassification of LE. The presence of C_5b?9 within skin lesions of patients with LE implies a pathogenic role for complement-mediated pore formation.     

The coexistence of systemic lupus erythematosus and psoriasis

Systemic and discoid lupus erythematosus (LE) have both been reported in association with psoriasis. Four additional patients who had systemic LE are reported. All of them had a high titer of antinuclear antibodies (ANAs) and were SS-A(Ro)-negative. Only one patient exhibited photosensitivity. SS-A(Ro) antibodies do not appear to be specific markers for the coexistence of LE and psoriasis, and screening for them in all psoriatics prior to ultraviolet B phototherapy is not recommended. Pitfalls in the management of patients with systemic LE and psoriasis are discussed.     

系统性硬皮病治疗前后血清ANA及ENA抗体检测的意义

目的：探讨ＡＮＡ、ＥＮＡ抗体与系统性硬皮病（ＳＳＤ）转归的关系。方法：免疫印迹法检测７种ＥＮＡ抗体，间接免疫荧光法检测ｄｓＤＮＡ、ＡＮＡ抗体。结果：ＳＳＤ中７种ＥＮＡ抗体阳性率为６４．７％，其中以抗Ｓｃｌ ７０抗体阳性率最高（４１．２％），治疗后抗Ｓｃｌ ７０抗体及抗Ｒｏ部分转阴，ＡＮＡ治疗前阳性率７３．５％，治疗后阳性率及滴度明显下降。结论：ＡＮＡ抗体可作为判断ＳＳＤ病情是否好转的参考指标，抗Ｓｃｌ ７０，抗Ｒｏ部分转阴是否与ＳＳＤ的好转有关，值得进一步观察。     

Expression of SS-A/Ro and SS-B/La antigens in skin biopsy specimens of patients with photosensitive forms of lupus erythematosus

CONTEXT: The reason that only some patients with lupus erythematosus (LE) develop autoantibodies to SS-A/Ro and SS-B/La antigens and photosensitivity is unknown. One hypothesis is that both events are related to the level of expression of these antigens in the skin. OBJECTIVE AND DESIGN: To test this hypothesis, we measured the expression of the 52-kd SS-A/Ro, 60-kd SS-A/Ro, and 48-kd SS-B/La antigens in normal sun-protected and sun-exposed skin in 14 patients with LE with photosensitivity, 12 patients with LE without photosensitivity, and 4 normal individuals. The presence of circulating antibodies to these antigens was measured in all patients. SETTING: Outpatient clinic in an academic medical center. RESULTS: We found that the expression of the 52-kd SS-A/Ro, 60-kd SS-A/Ro, and 48-kd SS-B/La antigens in skin biopsy specimens obtained from the same site was 4- to 10-fold higher in patients with LE with photosensitivity than in those patients with LE without photosensitivity (P<.001). Antigen expression was highly correlated with the presence and titer of circulating anti-SS-A/Ro and anti-SS-B/La antibodies (P<.001). CONCLUSIONS: These findings indicate that photosensitivity and the presence and titer of circulating anti-SS-A/Ro and anti-SS-B/La antibodies are both directly correlated with the expression of accessible and immunoreactive SS-A/Ro and SS-B/La antigens in the skin specimens of patients with LE. Thus, the expression of these antigens in keratinocytes may be an important determinant of the development of both SS-A/Ro and SS-B/La autoantibodies and of photosensitive forms of LE.     

Subacute lupus erythematosus of the skin--clinical aspects and laboratory findings

The data of 20 patients with subacute cutaneous lupus erythematosus (SCLE) were evaluated according to clinical and laboratory criteria. We found the following laboratory deviations: elevated BSR, leucopenia, anti-dsDNA, anti-SSA/Ro and anti-SSB/La antibodies, positive LE cells, and elevated levels of IgE and immune complex. Aside from the characteristic skin eruptions in SCLE, the patients showed arthralgia, myalgia, and pronounced photosensitivity. Therapy: corticoids, chloroquine, and light protection. Regular follow-up examinations are extremely important in these patients.     

Anti-basement membrane antibodies in sera from patients without bullous pemphigoid.

Sera from 208 individuals were examined for antibasement membrane (anti-BM) antibodies by means of an indirect immunofluorescence technique. In sera from patients with bullous pemphigoid 19 of 25 had anti-BM antibodies in titres varying from 80 to 32 000. In 2 of 42 sera from patients with psoriasis, anti-BM antibodies were demonstrated (titres 40-640). Of 58 sera from patients with leg ulcers, antibodies were found in 4 (titres 40-320). Antibodies were found in 2 of 43 patients with cardio-vascular disease (titre 80) and in 1 of 40 control persons (titre 40). Serum from one of the patients with leg ulcers caused a punctate staining pattern unlike the tubular pattern seen in all other positive sera.     

Lupus-erythematosus-like eruption induced by Trichophyton mentagrophytes infection

BACKGROUND: Several factors are known to trigger acute manifestations of lupus erythematosus (drugs, ultraviolet radiation, bacterial or viral infections, pregnancy), but fungal infections have never been reported to induce lupus-like lesions. We describe 2 children with tinea capitis caused by Trichophyton mentagrophytes(TM), who developed transient skin and serological manifestations of systemic lupus erythematosus. PATIENTS: Case 1, a 3-year-old girl, had a kerion due to TM transmitted by an octodon, and a facial skin eruption suggestive of systemic lupus erythematosus. Antinuclear antibodies (ANA) were positive at 1:250. After griseofulvin treatment, the lupus-like rash completely regressed, and the ANA titre decreased. Case 2, a 4-year-old girl, had occipital kerion and an annular scaly erythema on the shoulder caused by TM. She also had a non-scaly rash on the face and a recent history of photosensitivity. The ANA titre was positive at 1:8,000. Cutaneous lesions disappeared after an 8-week griseofulvin therapy, and ANA titres decreased progressively. CONCLUSIONS: 'New pets' are usually the vectors of TM, especially familiar rodents like the degu of Chile (also named octodon). In our 2 cases, lupus-like rashes began before the onset of griseofulvin treatment, suggesting a pathogenic role of the dermatophyte. A wide variety of lesions named 'mycides' was described several decades ago associated with TM infections. We hypothesize that these mycides and the TM-induced lupus-like lesions reported in our 2 cases could represent the same entity.     

Clinical, histological and immunological studies in 50 patients with bullous pemphigoid

Fifty patients with bullous pemphigoid were investigated over periods of up to 7 years. Sequential studies of circulating basement membrane zone (BMZ) antibody titres revealed two groups of patients: 44% had a high initial titre (greater than 1:160) and 56% had a low initial titre (less than 1:160). Subjects with titres greater than 1:160 continued to have high titres, whereas in those with lower titres the BMZ antibodies usually became undetectable after 4 months. The BMZ antibody titres were of no prognostic value. High titres remained high even in patients who were in remission and off treatment, and in these subjects, there was no evidence of a change in the IgG subclass. The initial BMZ IgG antibody titres showed a highly significant correlation with total serum IgE concentrations. A significant correlation also existed between total serum IgE and IgG4 concentrations, although not between the serum IgE and the peripheral blood eosinophil count. No anti-BMZ antibody of IgE class was found, nor specific IgE against inhalants and foods identified, and the significance of the high total serum IgE remains unexplained. The majority of those followed for more than 2 years were able to stop their steroid therapy without further blistering: this confirms that pemphigoid tends to be a self-limiting disease. Nine patients had a recent history of malignant disease, and this is no more than would be expected for this age group of patients: however, 3 patients presented with pemphigoid and figurate erythema and all died of neoplastic disease, suggesting that such patients should be investigated thoroughly for neoplasia.     

Interpretation of Chlamydia trachomatis antibody response in chlamydial oculogenital infection.

OBJECTIVE--To study: (a) the chlamydial antibody response (to the D-K serovars) using the micro-immunofluorescence (micro-IF) test in the following groups: (I) chlamydial genital infection only, (II) chlamydial ocular infection only, (III) combined chlamydial ocular and genital infection (oculo-genital infection), (IV) chlamydial ocular infection with chlamydia-negative non-gonococcal urethritis, (V) adenovirus conjunctivitis (control group 1), (VI) male partners of group I-IV with no chlamydial oculogenital infection or non-gonococcal urethritis (control group 2) (b) the cross reactivity of antibodies in patients' sera between the three chlamydial species and within the serovars of C trachomatis in those with culture-positive chlamydial oculo-genital infection. SETTING--oculogenital (diagnostic) clinic at Moorfields Eye Hospital, London, UK. SUBJECTS--209 consecutive patients attending the clinic with Chlamydia trachomatis oculogenital infection and 86 patients with adenovirus conjunctivitis (control group 1) and 55 male partners with no evidence of chlamydial oculogenital infection or non-gonococcal urethritis (control group 2). RESULTS--Of all the patients with proven chlamydial oculogenital infection, 10.5% (22/209) and 94% (197/209) had IgM and IgG antibodies respectively. The geometric mean IgG antibody titres (GMT) were 1:98, 1:123, 1:245 and 1:101 in groups I to IV respectively. The IgG GMT values seen in control groups 1 and 2 were 1:45 and 1:36 respectively. Only 2/86(2%) patients in group V (control group 1) had IgG chlamydial antibodies of 1:32 and 1:64, whilst only 1/55(1.8%) and 4/55(7.3%) of patients in group VI(control group 2) had chlamydial IgG antibody titres of > or = 1:256 and > or = 1:128 respectively. A four-fold rise or fall in IgG antibody titre occurred in 56%(107/192) of patient groups I-IV over 2-6 weeks. Low titre cross-reactive antibody responses against different chlamydial species and serovars were commonly seen; 71%(148/209) of all patients showed cross-reactivity with Chlamydia pneumoniae or psittaci species or both, whilst 92% (193/209) of patients showed some level of cross reactivity to other pooled serovars of C trachomatis (A-C and L 1-3). CONCLUSIONS--Serological diagnosis of chlamydial infection as evidenced by a positive IgM antibody response, high IgG titre (> or = 1:256) or > or = 4-fold rise or fall in IgG antibody titre was seen in 78%(163/209) of patients with culture-positive chlamydial oculogenital infection. Chlamydial IgG antibody titres of > or = 1:256 had a sensitivity of 42.6%, specificity of 98.2%, positive predictive value of 98.8% and a negative predictive value of 31% for chlamydial infection at any site, when considering groups I-IV and control group 2. In this study of 216 patients with conjunctivitis, a positive IgG antibody response (titre > or = 1:16) had a sensitivity of 98.5%, specificity of 97.7%, positive predictive value of 98.5% and a negative predictive value of 97.7%, for chlamydial conjunctivitis. Patients with dual chlamydial infection of conjunctiva and genital tract had a higher IgG GMT titre than those with ocular or genital infection alone: infection at a second site may produce an anamnestic response. Although the micro-IF test is a useful adjunct for the diagnosis of chlamydial infection, cross-reactivity between different chlamydial species and serovars is common. Chlamydial seroepidemiological studies should be interpreted with caution, as studies may attribute a serological response to a particular species or serovar in a setting where two or more are prevalent.     

Lack of antinuclear antibody in children with atopic dermatitis

Antinuclear antibody (ANA) was assayed in 76 children with atopic dermatitis (AD) of which 46 were males and 30 females. Their ages ranged from 6 months to 12 years (mean 3.4 years). Age at onset of AD ranged from 2 months to 5.5 years (mean 1.9 years) and its duration ranged from 4 months to 4 years (mean 1.2 years). While facial lesions were present in 56 (73.3%) patients, 49 (64.5%) patients had predominant involvement of extensors. As per severity score designed by Rajka and Langerland, 31 (40.8%), 42 (55.3%) and 3 (3.9%) patients had mild, moderate and severe diseases respectively. History of photosensitivity was present in 6 (7.9%) patients. Serum samples were positive for ANA in a very low titre (1:20) in 2/6 patients with facial lesions. However LE cell, rheumatoid factor and C-reactive proteins were negative and serum complement levels were within normal limits.     

Occurrence of polymorphous light eruption in lupus erythematosus

Photosensitivity is a well–known manifestation of lupus erythematosus (LE). Since there are no strict criteria for photosensitivity, varying prevalence figures have been reported. Also, distinction from polymorphous light eruption (PLE) can be difficult. The purpose of this study was to characterize photosensitivity in more detail and to determine the occurrence of PLE in a series of well–documented LE patients. A questionnaire was answered by 337 LE patients seen at dermatology departments in Finland and Sweden, and 63 of the patients were invited for interview. According to the questionnaire. LE lesions were made worse by sunlight in 242 (72%) patients. Symptoms consistent with PLE were reported by 165 (49%) patients. Detailed personal interviews supported the results from the questionnaire, and revealed that PLE had started 2–45 years before the onset of LE in 23 of 37 patients with both diagnoses, and more than 7 years before in 18 of 37 (49%). PLE proved to be common in patients with both systemic and cutaneous LE. The two conditions may often coexist and, in about half of the cases, PLE preceded LE. These two diseases may share pathogenic factors, PLE might predispose to LE in a subgroup of PLE patients.     

成人皮肌炎患者抗核抗体与临床特征及肿瘤风险的关系

目的 探讨成人皮肌炎患者抗核抗体与临床特征及肿瘤风险的关系.方法 回顾性分析2008年4月至2018年4月在苏州大学附属第一医院皮肤科住院的101例皮肌炎患者的临床资料,分为抗核抗体阳性组和阴性组,比较两组之间肌病、肿瘤发生风险以及其他临床特征的差异.92例患者随访2年.采用卡方检验分析比较两组的临床特征,利用多因素回...     

Autoantibodies in psoriasis as predictors for loss of response and anti-infliximab antibody induction

Background Infliximab is successfully used to treat psoriasis and psoriatic arthritis. However, some patients lose therapeutic response after several cycles. Antibodies to infliximab (infliximab‐Abs) are induced during treatment in a subgroup of patients and are thought to be associated with loss of response (LOR). Routine screening for infliximab‐Abs is expensive and not regularly performed. A reliable and affordable method for identifying patients who are at risk for LOR to infliximab is desirable. Objectives To analyse the development of antinuclear antibodies (ANA)/antidouble‐stranded DNA antibodies (anti‐dsDNA) over time in patients with psoriasis receiving infliximab. To analyse if there is an association between ANA titres/anti‐dsDNA concentrations, infliximab‐Ab status and LOR. Methods A retrospective data analysis of 29 patients with psoriasis receiving infliximab was carried out. ANA titres and anti‐dsDNA concentrations were regularly monitored in these patients and sera were tested for infliximab‐Abs by enzyme‐linked immunosorbent assay. Results Median ANA titres increased from 1 : 80 [interquartile range (IQR) 0 to 1 : 320, n = 29] pretreatment, to 1 : 1280 (IQR 1 : 640 to 1 : 1920, n = 15) after infusion 10, and 1 : 1920 (IQR 1 : 1280 to 1 : 2560, n = 10) after infusion 20. Infliximab‐Abs were found in 21% of patients. Infliximab‐Ab‐positive patients and patients with LOR had significantly higher pretreatment anti‐dsDNA concentrations and higher pretreatment ANA titres than infliximab‐Ab‐negative and responsive patients, respectively. Conclusions The results of this study suggest a role for autoantibodies in the identification of patients with psoriasis at higher risk of developing infliximab‐Abs and of LOR under treatment with infliximab.