临床与医学基因组学杂志

Which Skin Lupus Criteria are of More Value in Determining the Disease: A Greater View with the Help of Direct Immune Fluorescent (DIF)

Abstract

Sahra Emamzadehfard and Alireza Ghannadan

Background: Lupus erythematosus (LE) includes a spectrum of auto immune disorders, involving whole body (systemic LE) in one end and is cutaneous limited LE on the other side. Cutaneous LE mainly diagnosed via clinical manifestations as well as histopathologic examination. According to different pathologic specifications, the aim of present study was to determine which histopathologic criterion is more accurate and practical in diagnosing cutaneous LE.

Material and Methods: The Samples which have been taken were from the patients with clinical manifestations of Cutaneous LE with pathologic confirmation. All patients had direct immuno fluorescent (DIF) samples that recorded. Histopathologic findings are categorized into three groups: group 1 contains epidermal changes, group 2 includes interface changes and group 3 contains dermal changes. Different histopathologic finding such as prevascular infiltration, follicular atrophy, follicular plaque, and basements membrane thickness and other changes, as well as DIF patterns, were recorded in designed questionnaires. Further analysis had been done with SPSS software version 22.

Results: Of 145 patients (61.4% female and 38.6% male) in 58.6% DLE was the first clinical diagnosis, 23% was the second and in subsequent 4.1%, 1.4% and 0.7% was third, fourth and fifth diagnosis respectively. In 11% of caeses DLE was not among clinical impressions. DIF was positive in 49%. As a whole, superficial perivascular and perifolicular infiltration were observed in 99% of the cases and was the commonest pathologic feature followed by basal vacuolization, peri follicular infiltration and epidermal atrophy. Other pathologic changes were observed with variable rates.

Discussion: By grouping histopathologic criterion, it seems that hyperkeratosis and thickening of Basement membrane may be major histologic criterion and peri vascular infiltration, peri follicular infiltration and eccrine gland infiltration, may be minor.