Clinicopathological significance of cutaneous epidermal nuclear staining by direct immunofluorescence |
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Authors: | N P Burrows B S Bhogal R Russell Jones M M Black |
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Institution: | Department of Immunofluorescence, Institute of Dermatology, UMDS, St Thomas' Hospital, London, UK. |
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Abstract: | Epidermal antinuclear antibody (ANA) staining was noted during routine direct immunofluorescence (DIF) of skin biopsies from 22 cases at St John's Dermatology Centre over a 2-year period. We have reviewed the clinical, serological and immunopathological features of these patients. They comprised 13 cases of lupus erythematosus (LE), 3 dermatomyositis, 1 morphoea, 1 systemic sclerosis, 1 CREST syndrome, 1 mixed connective tissue disorder and 1 probable cutaneous sarcoidosis. Five (38.4%) patients with LE had moderate to severe oral mucosal involvement. Epidermal nuclear staining (ENS) was seen following IgG deposition in 21 cases and IgA in only 1 case. Complement C3 staining was an additional feature in 1 patient. Circulating ANA was absent in 7 cases at the time of biopsy, confirming that this pattern of staining does not occur as a result of tissue con-lamination during processing. The presence of ENS by IMF corroborates a diagnosis of a connective tissue disorder, and our results suggest that it may also be associated with oral involvement in E.E. |
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