Pincer Nail Deformity Associated with Systemic Lupus Erythematosus

Background: Systemic lupus erythematosus (SLE) is an autoimmune disorder with various systemic and cutaneous manifestations. Nail abnormalities, including onycholysis, red lunulae, pitting, and ridging, have been seen in patients with the disorder. To our knowledge, however, pincer nail deformity has yet to be reported coincident with the onset of SLE. Objective: We report a case of pincer nail deformity subsequent to the development of SLE and describe surgical treatment of the deformed nails. This is followed by a review of the literature. Conclusion: Acquired pincer nail is a dystrophy with numerous reported causative associations, including psoriasis, tumors of the nail apparatus, tinea ungium, ß-blocker usage, and now SLE. Pain from the resulting constriction can interfere greatly with daily activities and can be debilitating to the extent of requiring therapy.

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Unilateral facial erythematous patch as the presenting sign of systemic lupus erythematosus

Lupus ◽

10.1177/0961203320957739 ◽

2020 ◽

Vol 29 (14) ◽

pp. 1968-1970

Author(s):

Dae-Lyong Ha ◽

Gi-Wook Lee ◽

Kihyuk Shin ◽

Hoon-Soo Kim ◽

Hyun-Chang Ko ◽

...

Keyword(s):

Systemic Lupus Erythematosus ◽

Lupus Erythematosus ◽

Autoimmune Disorder ◽

Left Cheek ◽

Systemic Lupus ◽

Diagnostic Challenge ◽

Cutaneous Manifestations ◽

Oral Ulcers ◽

Rare Manifestation ◽

History Of

Systemic lupus erythematosus (SLE) is a chronic autoimmune disorder that can have many cutaneous manifestations including malar rash, discoid rash or oral ulcer. Isolated unilateral involvement of face is uncommon in SLE. It lacks typical clinical features of LE, and may impose a diagnostic challenge for clinicians. Herein we report a case of 62-year-old woman presenting with a 2-year history of erythematous patches on left cheek and eyelid. Initially, she was diagnosed as having recurrent blepharitis or cellulitis that did not respond to conventional treatment with ophthalmic medicaments. As time went by, the patches spread to her left cheek, and she was referred to our dermatologic department. Histopathologic examination was consistent with LE. Further physical and laboratory tests have found that she had oral ulcers, proteinuria, thrombocytopenia and abnormal titer of anti-nuclear antibody satisfying the diagnosis of SLE. From this case, we think unilateral erythematous patches on face could be a rare manifestation of SLE and more intention should be paid to this type of patients, because unilateral facial symptom may mimic other dermatoses.

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Atypical dermatophytosis in a case of systemic lupus erythematosus

Our Dermatology Online ◽

10.7241/ourd.2020e.165 ◽

2020 ◽

Vol 11 (e) ◽

pp. e165.1-e165.3

Author(s):

Manjunath M Shenoy ◽

Goutham Kilaru ◽

Ashmiya Razak ◽

Malcolm Pinto

Keyword(s):

Systemic Lupus Erythematosus ◽

Lupus Erythematosus ◽

Cutaneous Lupus Erythematosus ◽

Autoimmune Disorder ◽

Laboratory Evaluation ◽

Systemic Lupus ◽

Cutaneous Manifestations ◽

Therapeutic Implications ◽

The Face ◽

Erythematous Plaques

Systemic lupus erythematosus (SLE) is a multiorgan autoimmune connective tissue disease with many muco-cutaneous manifestations. We report a case of SLE on treatment presented with scaly erythematous plaques on the trunk and extremities and diffuse scaly erythematous macular lesions on the face resembling cutaneous lupus erythematosus. Laboratory evaluation established a diagnosis of tinea corporis with faciei. He responded to long term itraconazole therapy. This case focuses on the modification of tinea in an autoimmune disorder on immunosuppressive therapy and its therapeutic implications.

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AB0419 THE COEXISTENCE OF FAMILIAL MEDITERRANEAN FEVER (FMF) IN SYSTEMIC LUPUS ERYTHEMATOSUS (SLE) PATIENTS - A CROSS SECTIONAL STUDY

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.2305 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 1509.1-1510

Author(s):

T. Klein ◽

S. Tiosano ◽

A. Chohen ◽

H. Amital

Keyword(s):

Systemic Lupus Erythematosus ◽

Familial Mediterranean Fever ◽

Lupus Erythematosus ◽

Cross Sectional Study ◽

Review Of The Literature ◽

Sectional Study ◽

Systemic Lupus ◽

Cross Sectional ◽

Mediterranean Fever ◽

Age And Sex

Background:Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease characterized by multisystem inflammatory lesions affecting many organ systems in the body. Familial Mediterranean fever (FMF) is an autosomal recessive disease of chronic autoimmune inflammation characterized by frequently relapsing self-limiting fever and inflammation that may be localized in peritoneum, pleura, joint or skin.1Previous studies have described the similarity of clinical symptoms of FMF among SLE patients. However, the literature on this topic is inconsistent and based mostly on case reports.2-4Objectives:To examine the proportions of coexistence of FMF among SLE patients compared to the general population. We hypothesized that the proportion of FMF among SLE patients is higher than the general population.Methods:This cross-sectional study used the Clalit Health Services database, the largest Health Maintenance Organization in Israel, serving 4,400,000 members. SLE patients were compared to age- and sex-matched controls. Chi- was used for univariate analysis.Results:The study included4886 SLEpatients and 24430 age- and sex-matched controls. The SLE group had a significantly higher proportion of FMF patients compared to non-SLE controls (0.68% and 0.21% respectively; p < 0.001).Table 1. All study populationTable 1.SLE patients and matched controls basic characteristicsNo SLESLEp.overallN=24430N=4886Age51.2±16.551.2±16.51.000Gender: Female20100 (82.3%)4020 (82.3%)1.000FMF52 (0.21%)33 (0.68%)<0.001Table 2. StratificationTable 2.comparison of FMF patients with and without SLEFMF without SLEFMF with SLEp.overallN=52N=33Age44.6±13.750.5±17.70.106Gender: Female45 (86.5%)26 (78.8%)0.523Conclusion:FMF was found to be more common amongst SLE patients compared to matched controls.The current study results suggest that the occurrence of SLE turn patients with an appropriate genetic and environmental setting to develop also FMF. This cross-sectional study sheds light on the coexistence of these two diseases, autoimmune and autoinflammatory.References:[1]Kucuk A, Gezer IA, Ucar R, Karahan AY. Familial mediterranean fever.Acta Medica (Hradec Kralove). 2014;57(3):97-104.[2]Lidar M, Zandman-Goddard G, Shinar Y, Zaks N, Livneh A, Langevitz P. SLE and FMF: A possible negative association between the two disease entities–report of four cases and review of the literature.Lupus. 2008;17(7):663-669.[3]Erten S, Taskaldiran I, Yakut ZI. Are systemic lupus erythematosus patients carrying MEFV gene less prone to renal involvement? report of three cases and review of the literature.Ren Fail. 2013;35(7):1013-1016.[4]Shinar Y, Kosach E, Langevitz P, et al. Familial mediterranean Fever gene (MEFV) mutations as a modifier of systemic lupus erythematosus.Lupus. 2012;21(9):993-998.Disclosure of Interests: :None declared

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AB0013 ASSOCIATION BETWEEN STAT4 POLYMORPHISM AND MANIFESTATIONS OF SLE

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.3470 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 1041.1-1041

Author(s):

V. Agarwal ◽

S. Kakati ◽

P. Debbaruah

Keyword(s):

Systemic Lupus Erythematosus ◽

Lupus Erythematosus ◽

Indian Population ◽

Association Studies ◽

Statistical Significance ◽

Elevated Serum ◽

Systemic Lupus ◽

Cutaneous Manifestations ◽

Genotype Group ◽

Dsdna Antibody

Background:SNP rs7574865, located within the third intron of STAT4 gene at chromosome 2, has been associated with susceptibility to SLE among different ethnic groups.1,2 Interestingly, we recently have documented an association between this gene and susceptibility to systemic lupus erythematosus (SLE) in Indian population.3Objectives:To determine whether the STAT4 (rs7574865) SNP is associated with clinical and immunological manifestations in SLE.Methods:The study was carried out on 100 unrelated SLE (SLICC criteria 2012) patients from North-East India. Genotyping of STAT4 rs7574865 SNP was done using Taqman probe and Real-Time Polymerase chain reaction. An association study was performed between the alleles and genotypes of STAT4 rs7574865 with the clinical and immunological manifestations included in the SLE SLICC classification criteria. For all analysis, the statistical significance was fixed at 5% level of significance (p < 0.05).Results:The mean duration of illness was 2.69±2.55 years. Cases and Controls remained in Hardy-Weinberg equilibrium.The occurrence of Photosensitivity and hyperpigmentation was significantly higher in TT genotype group (97.22% and 77.77%, respectively) with p <0.001 in each case.SLE patients with nephritis (Albuminuria >500mg/24 hours) and elevated serum creatinine were both significantly higher in TT genotype group as compared to GT and GG (p< 0.001 and p=0.001 respectively).The Anti-dsDNA antibody was significantly associated with TT genotype (p <0.001).Conclusion:Our study provides evidence regarding the association between STAT4 rs7574865 gene polymorphism is risk factor for cutaneous manifestations, Lupus nephritis and Anti ds-DNA positivity in SLE. So, our findings reinforce the need for further association studies including prospective studies with larger subjects in order to replicate such findings.References:[1]Graham RR, Ph D, Hom G, Ph D, Behrens TW, Bakker PIW De, et al. and the Risk of Rheumatoid Arthritis and Systemic Lupus Erythematosus. N Engl J Med. 2007;357(10):977–86.[2]Yuan H, Feng JB, Pan HF, Qiu LX, Li LH, Zhang N, et al. A meta-analysis of the association of STAT4 polymorphism with systemic lupus erythematosus. Mod Rheumatol. 2010;20(3):257–62.[3]Gupta V, Kumar S, Pratap A, Singh R, Kumari R, Kumar S, et al. Association of ITGAM, TNFSF4, TNFAIP3 and STAT4 gene polymorphisms with risk of systemic lupus erythematosus in a North Indian population. Lupus. 2018;27(12):1973–9.Disclosure of Interests:None declared

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Characterization of the thrombin generation profile in systemic lupus erythematosus

Physiology International ◽

10.1556/2060.104.2017.1.5 ◽

2017 ◽

Vol 104 (1) ◽

pp. 35-41 ◽

Cited By ~ 4

Author(s):

A Kern ◽

E Barabás ◽

A Balog ◽

Sz Burcsár ◽

M Kiszelák ◽

...

Keyword(s):

Systemic Lupus Erythematosus ◽

Lupus Erythematosus ◽

Thrombin Generation ◽

Area Under The Curve ◽

Autoimmune Disorder ◽

Systemic Lupus ◽

Time To Peak ◽

Cat Assay ◽

Coagulation Tests ◽

Healthy Control

Systemic lupus erythematosus (SLE) is a multisystemic inflammatory autoimmune disorder. Thrombotic events occur at a higher incidence among SLE patients. The investigation of thrombin generation (TG) with calibrated automated thrombogram (CAT) test as a global hemostasis assay is applicable for the overall functional assessment of the hemostasis. The aim of this study was to characterize the hemostatic alterations observed in SLE by CAT assay. In this study, CAT parameters and basic coagulation parameters of SLE patients (n = 22) and healthy control subjects (n = 34) were compared. CAT area under the curve (i.e., endogenous thrombin potential) was lower than normal in SLE (807 vs. 1,159 nM*min, respectively), whereas other CAT parameters (peak, lag time, time to peak, and velocity index) and the basic coagulation tests were within the normal range. The presence of anti-phospholipid antibodies and the applied therapy was not associated with hemostasis parameters in SLE. We concluded that the reported high risk of thrombosis is not related to TG potential.

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A case of neuromyelitis optica (Devic's syndrome) in systemic lupus erythematosus: Clinicopathologic report and review of the literature

Neurology ◽

10.1212/wnl.26.11.1066 ◽

1976 ◽

Vol 26 (11) ◽

pp. 1066-1066 ◽

Cited By ~ 85

Author(s):

R. S. APRIL ◽

E. VANSONNENBERG

Keyword(s):

Systemic Lupus Erythematosus ◽

Neuromyelitis Optica ◽

Lupus Erythematosus ◽

Review Of The Literature ◽

Systemic Lupus ◽

Devic’S Syndrome

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MiR-410 Down-Regulates the Expression of Interleukin-10 by Targeting STAT3 in the Pathogenesis of Systemic Lupus Erythematosus

Cellular Physiology and Biochemistry ◽

10.1159/000445625 ◽

2016 ◽

Vol 39 (1) ◽

pp. 303-315 ◽

Cited By ~ 23

Author(s):

Dongmei Liu ◽

Na Zhang ◽

Xiaomei Zhang ◽

Muting Qin ◽

Youdan Dong ◽

...

Keyword(s):

Systemic Lupus Erythematosus ◽

T Cells ◽

Lupus Erythematosus ◽

Autoimmune Disorder ◽

Interleukin 10 ◽

Luciferase Assay ◽

Mrna Levels ◽

Healthy Controls ◽

Systemic Lupus ◽

Targeting Effect

Background/Aims: Systemic lupus erythematosus (SLE) is a heterogeneous chronic inflammatory autoimmune disorder, in the pathogenesis of which miRNAs play a versatile function. The purpose of this study was to investigate the effect of miRNA-410 on the pathogenesis of SLE in T cells of SLE patients. Methods: Real-time PCR was used to test the mRNA levels of miRNA-410 in SLE patients and healthy controls. ELISA analysis was performed to examine the production levels of IL-10. Luciferase Assay was used to confirm the targeting effect of miRNA-410 on 3'UTR of STAT3 mRNA. Results: We found that the expression level of miR-410 in T cells of SLE patients was decreased comparing to that in healthy controls, whereas overexpression of miR-410 significantly reduced the expression levels of IL-10. Furthermore, miR-410 suppresses the transcription activity of STAT3 by binding directly to the 3 'UTR of STAT3 mRNA. Moreover, silence of STAT3 down regulated IL-10 expression in CD3+ T cells. Conclusion: Our results demonstrate that miR-410 is the key regulatory factor in the pathogenesis of SLE by regulating the expression of IL-10 through targeting STAT3. These data suggest a novel function of miR-410 and bring new insight into understanding the complex mechanisms involved in SLE.

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Optic Neuropathy in Systemic Lupus Erythematosus and Antiphospholipid Syndrome (APS): Clinical Features, Pathogenesis, Review of the Literature and Proposed Ophthalmological Criteria for APS Diagnosis

Clinical Rheumatology ◽

10.1007/s100670050069 ◽

1999 ◽

Vol 18 (2) ◽

pp. 124-131 ◽

Cited By ~ 43

Author(s):

D. Giorgi ◽

C. Balacco Gabrieli

Keyword(s):

Systemic Lupus Erythematosus ◽

Clinical Features ◽

Antiphospholipid Syndrome ◽

Optic Neuropathy ◽

Lupus Erythematosus ◽

Review Of The Literature ◽

Systemic Lupus

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A Case of Thrombotic Thrombocytopenia Purpura Associated with Systemic Lupus Erythematosus: Diagnostic Utility of ADAMTS-13 Activity

Autoimmune Diseases ◽

10.4061/2011/483642 ◽

2011 ◽

Vol 2011 ◽

pp. 1-6 ◽

Cited By ~ 2

Author(s):

Risa Yamada ◽

Kazuhisa Nozawa ◽

Takashi Yoshimine ◽

Yoshinari Takasaki ◽

Hideoki Ogawa ◽

...

Keyword(s):

Systemic Lupus Erythematosus ◽

Lupus Erythematosus ◽

Thrombotic Microangiopathy ◽

Autoimmune Disorder ◽

Accurate Diagnosis ◽

Diagnostic Utility ◽

Systemic Lupus

Thrombotic thrombocytopenia purpura (TTP) caused by a deficiency in ADAMTS-13 activity is considered to involve a subset of thrombotic microangiopathy (TMA). Although concept of TTP is included under the umbrella of TMA, discrimination of TTP from TMA is occasionally difficult in an autoimmune disorder. Herein, we report a case with TTP associated with systemic lupus erythematosus (SLE). In this case, it was difficult to discriminate TTP from TMA and the measurement of ADAMTS-13 activity was useful for obtaining an accurate diagnosis. SLE patients having thrombocytopenia in complication with anemia should be considered a monitoring of ADAMTS-13 activity even though the patients lacked symptoms of TTP related to the microvascular coagulation.

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