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September 1976

Antinuclear Antibodies in Lupus Erythematosus

Arch Dermatol. 1976;112(9):1329. doi:10.1001/archderm.1976.01630330083042

To the Editor.—  In the recent article by Prystowsky and Gilliam (Arch Dermatol 111:1448, 1975), the authors stated that the "speckled" pattern was seen in patients with both systemic lupus erythematosus (SLE) and discoid lupus erythematosus (DLE). This is a particularly unfortunate choice of terminology as it perpetuates the confusion that exists regarding nuclear immunofluorescent pattern nomenclature. True speckles consist of multiple, evenly distributed, small round "pepper dots" and are mainly seen in scleroderma and Raynaud disease but not in LE.1 Conversely, another particulate nonhomogeneous pattern, the thready pattern, is seen primarily in LE, occasionally in scleroderma, but not in rheumatoid arthritis. There are at least nine particulate patterns that may be seen in LE.2 These patterns must be differentiated from the true speckles.3 True speckles were not seen in any of the 533 patients with LE that we studied.1 The "speckles" that the authors found