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September 12, 1977

Immune Deposits in Normal Skin in Infective Endocarditis

JAMA. 1977;238(11):1182. doi:10.1001/jama.1977.03280120074023

In systemic lupus erythematosus (SLE) and rheumatoid arthritis, the various skin lesions are associated with the presence of immune deposits, suggesting that they may be important in the genesis of the skin lesions. In addition, immunoglobulins and complement have been found in normal-appearing skin in these diseases. Immunoglobulin deposits at the dermal-epidermal junction of clinically uninvolved skin are found in approximately 50% of patients with SLE.1 The localization of the immune deposits at the dermal-epidermal junction in SLE may be due to the affinity of DNA for connective tissue in that area.2 Immune deposits are found in subepidermal vessels in normal-appearing skin in patients with seropositive rheumatoid arthritis.3 The localization of immune deposits in rheumatoid arthritis is in small vessels, as in the Arthus reaction.

It is not clear why the immune deposits may result in skin lesions in some situations and not in others. Such factors