Immunopathology and Pathogenesis of Cutaneous Lupus Erythematosus

  • James N. Gilliam
Part of the Comprehensive Immunology book series (COMIMUN, volume 7)


Systemic lupus erythematosus (SLE) is a multisystem disease of unknown etiology. It may be acute and fulminating or slowly progressive, with characteristic exacerbations and remissions. Most investigators agree that the clinical expression of lupus erythematosus forms a spectrum from chronic cutaneous lupus erythematosus (known as discoid LE or DLE) to the often fatal, multisystem LE with nephritis. In studying this clinical spectrum, we have examined clinical and serological data from several distinct subsets of patients with LE. These studies indicate that LE may be viewed not only in a spectrum, or continuum, from a clinicopathological standpoint, but also in a related spectrum of immunological responses. An understanding of these clinical, serological, and immunopathological relationships is helpful in the diagnosis and management of these patients and provides insight into the pathogenesis of the disease.


Systemic Lupus Erythematosus Skin Lesion Systemic Lupus Erythematosus Patient Cutaneous Lupus Erythematosus Follow Bone Marrow Transplantation 
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  1. Allison, A. C., Denman, A. M., and Barnes, R. D., 1971, Cooperating and controlling functions of thymus-derived lymphocytes in relation to autoimmunity, Lancet 2: 135–140.PubMedCrossRefGoogle Scholar
  2. Burnham, T. K., and Fine, G., 1971, The immunofluorescent “band” test for lupus erythematosus, Arch. Dermatol. 103: 24–32.PubMedCrossRefGoogle Scholar
  3. Cohen, A. S., Reynolds, W. E., Franklin, E. C., Kerlka, J. P., Ropes, M. W., Shulman, L. E., and Wallace, S. L., 1971, Preliminary criteria for the classification of systemic lupus erythematosus, Bull. Rheum. Des. 21: 643.Google Scholar
  4. Cripps, D. J., and Rankin, J., 1973, Action spectra of lupus erythematosus and experimental immunofluorescence, Arch. Dermatol. 107: 563–567.PubMedCrossRefGoogle Scholar
  5. Dubois, E. L., and Tuffanelli, D. L., 1964, Clinical manifestations of systemic lupus erythematosus, J. Am. Med. Assoc. 170: 104–111.CrossRefGoogle Scholar
  6. Estes, D., and Christian, C. L., 1971, The natural history of systemic lupus erythematosus by prospective analysis, Medicine 50: 85–95.PubMedCrossRefGoogle Scholar
  7. Fries, J. F., 1977, The clinical aspects of systemic lupus erythematosus, Med. Clin. North Am. 61: 229–240.Google Scholar
  8. Fukuyama, K., and Bernstein, I. A., 1961, Autoradiographic studies of the incorporation of thymidine-H3 into deoxyribonucleic acid in the skin of young rats, J. Invest. Dermatol. 36: 312–326.Google Scholar
  9. Gilliam, J. N., 1975, The significance of cutaneous immunoglobulin deposits in lupus erythematosus and NZB/ NZW Fr hybrid mice, J. Invest. Dermatol. 65: 154–161.PubMedCrossRefGoogle Scholar
  10. Gilliam, J. N., and Cox, A. J., 1973, Epidermal changes in B12 deficiency, Arch. Dermatol. 107: 231–236.PubMedCrossRefGoogle Scholar
  11. Gilliam, J. N., Cheatum, D. E., Hurd, E. R., Stastny, P., and Ziff, M., 1974 Immunoglobulin in clinically uninvolved skin in systemic lupus erythematosus, J. Clin. Invest. 53: 1434–1438.PubMedCrossRefGoogle Scholar
  12. Grossman, J., Callerme, M. L., and Condemi, J. J., 1974, Skin immunofluorescence studies on lupus erythematosus and other anti-nuclear antibody positive diseases, Ann. Intern. Med. 80: 496–500.PubMedGoogle Scholar
  13. Hood, A. F., Soter, N. A., Rappeport, J., and Gigli, I., 1977, Graft-versus-host reaction-cutaneous manifestations following bone marrow transplantation, Arch. Dermatol. 113: 1087–1091.PubMedCrossRefGoogle Scholar
  14. Jablonska, S., Chorzelski, T., and Maciejowska, E., 1970, The scope and limitations of the immunofluorescence method in the diagnosis of lupus erythematosus, Br. J. Dermatol. 83: 242–247.PubMedCrossRefGoogle Scholar
  15. Janis, J. F., and Winkleman, R. K., 1963, Histopathology of the skin in dermatomyositis, Arch. Dermatol. 97: 640–650.CrossRefGoogle Scholar
  16. Kennedy, B. J., Smith, R., and Goltz, R. W., 1975, Skin changes secondary to hydroxyurea therapy, Arch. Dermatol. 111: 183–187.PubMedCrossRefGoogle Scholar
  17. Kyle, R. A., Schwartz, R. S., Oliner, H. L., and Damishek, W., 1961, A syndrome resembling adrenal cortical insufficiency associated with long term busulfan (Myleran) therapy, Blood 18: 497–510.PubMedGoogle Scholar
  18. Lai A Fat, R. F. M., Cormane, R. H., and Van With, R., 1974, An immunohistopathological study on the synthesis of immunoglobulin and complement in normal and pathological skin and the adjacent mucous membranes, Br. J. Dermatol. 90: 123–126.CrossRefGoogle Scholar
  19. Lerner, K. G., Kao, G. F., Storb, R., Buckner, C. D., Cliff, R. A., and Thomas, E. D., 1974, Histopathology of graft-vs.-host reaction (GVHR) in human recipients of marrow from HL-A matched sibling donors, Transplant. Proc. 6: 367–371.PubMedGoogle Scholar
  20. Lever, W. F., 1967, Histopathology of the Skin, Lippincott, Philadelphia.Google Scholar
  21. Nesbitt, L. T., and Gum, O. B., 1973, Direct cutaneous immunofluorescent test in lupus erythematosus, South. Med. J. 66: 991–997.PubMedCrossRefGoogle Scholar
  22. Pennebaker, J. B., Gilliam, J. N., and Ziff, M., 1977, Immunoglobulin classes of DNA binding activity in serum and skin in systemic lupus erythematosus, J. Clin. Invest. 60: 1331–1338.PubMedCrossRefGoogle Scholar
  23. Percy, J. C., and Smith, C. J., 1969, The immunofluorescent skin test in systemic lupus erythematosus, J. Am. Med. Assoc. 203: 485–488.CrossRefGoogle Scholar
  24. Pinkus, H., 1973, Lichenoid tissue reactions, Arch. Dermatol. 107: 840–846.PubMedCrossRefGoogle Scholar
  25. Prystowsky, S. D., and Gilliam, J. N., 1975, Discoid lupus erythematosus as part of a larger disease spectrum, Correlation of clinical features with laboratory findings in lupus erythematosus, Arch. Dermatol. 111: 1448–1452.PubMedCrossRefGoogle Scholar
  26. Prystowsky, S. D., Herndon, J. H., and Gilliam, J. N., 1975, Chronic cutaneous lupus erythematosus (DLE)a clinical and laboratory investigation of 80 patients, Medicine 55: 183–191.CrossRefGoogle Scholar
  27. Scott, A., and Rees, E. G., 1959, The relationship of systemic lupus erythematosus and discoid lupus erythematosus, Arch. Dermatol. 79: 422–435.CrossRefGoogle Scholar
  28. Stastny, P., and Ziff, M., 1971, Antibodies against cell membrane constituents in systemic lupus erythematosus and related diseases, Clin. Exp. Immunol. 8: 543.PubMedGoogle Scholar
  29. Stastny, P., Stembridge, V. A., and Ziff, M., 1963, Homologous disease in the adult rat, A model for autoimmune disease, General features and cutaneous lesions, J. Exp. Med. 11: 635–648.CrossRefGoogle Scholar
  30. Tay, C. H., 1970, Cutaneous manifestations of systemic lupus erythematosus, Aust. J. Dermatol. 11: 30–41.CrossRefGoogle Scholar
  31. Turk, J. L., 1976, Leprosy as a model of subacute and chronic immunologic diseases, J. Invest. Dermatol. 67: 457–463.PubMedCrossRefGoogle Scholar
  32. Woodruff, J. M., Hansen, J. A., Good, R. A., Santos, G. W., and Slavin, R. E., 1976, The pathology of the graftversus-host reaction (GVHR) in adults receiving bone marrow transplants, Transplant. Proc. 8: 675–684.PubMedGoogle Scholar

Copyright information

© Plenum Publishing Corporation 1981

Authors and Affiliations

  • James N. Gilliam
    • 1
  1. 1.Department of DermatologyUniversity of Texas Health Science CenterDallasUSA

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