ABSTRACT Introduction: Cutaneous lupus erythematosus (CLE) has a multitude of clinical and histopathological manifestations. There are a few Indian studies correlating clinical manifestations with antibody profiles, but none on histologically proven cases. This is important as CLE may be identified on biopsies in the absence of clinical suspicion. Objectives: (1) To describe serum autoantibody profiles in CLE. (2) To compare histopathological features in antibody-positive versus negative cases. Materials and Methods: This is a retrospective review of 175 biopsy-proven CLE with serology testing over 8 years. The parameters included anti-nuclear antibody (ANA), dsDNA, and ANA profile. Slides of discoid lupus erythematosus (DLE) were reviewed. Results: There was a female predominance, and the mean age was 51 years. Lupus erythematosus (LE) was suspected clinically in 132 cases. DLE was the most common (72%), followed by LE alopecia (13%) and bullous LE (3.4%). Ninety-three cases were autoantibody positive (53%). The most common pattern on ANA-IF was speckled (64.4%), followed by homogenous (27.6%). On the ANA profile, 39/55 (70.9%) were positive for one or more antibodies, the most common being RnP/Sm, SS-A, and Ro52. Among the histopathological types, acute LE (100%), bullous LE (66%) and lupus panniculitis (60%) had the highest positivity. In DLE, interface dermatitis was associated with ANA-positivity. There was no statistically significant difference in ANA-IIF positivity between DLE and the other subtypes. Conclusion: This is the first Indian study describing autoantibody profiles in histologically proven CLE. The spectrum of antibodies seen is consistent with the literature. However, almost half are negative for autoantibodies at presentation, augmenting the need for histopathology.
Bhavya et al. (Thu,) studied this question.