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August 1978

Development of Photosensitivity and an SLE-like Syndrome in a Patient With Psoriasis

Author Affiliations

From the Departments of Dermatology (Drs Millns and Muller) and Rheumatology (Dr McDuffie), Mayo Medical School, Mayo Clinic and Foundation, Rochester, Minn, and the Division of Dermatology, Medical College of Wisconsin, Milwaukee County General Hospital (Dr Jordon).

Arch Dermatol. 1978;114(8):1177-1181. doi:10.1001/archderm.1978.01640200031008

• An unusual case of photosensitive psoriasis and systemic lupus erythematosus-related syndrome was characterized by erythroderma, chronic urticaria, angioneurotic edema, intermittent lowgrade fever, and polyarthralgias. Investigation revealed no measurable total hemolytic complement and markedly diminished levels of C4, C2, and C3. Microscopic examination of three skin biopsy sections of sun-exposed skin showed psoriasis. Skin biopsy sections of sunexposed psoriatic plaques and of non-sun-exposed, uninvolved skin (which were stained with fluorescein-tagged anti-IgG, anti-IgM, anti-IgA, and anti-C3) showed granular deposits of IgM and C3 at the dermal-epidermal junction in the sun-exposed plaques, and IgM alone in a granular pattern at the dermal-epidermal junction in uninvolved skin. Antibodies to single-stranded but not double-stranded DNA were detected in the patient's serum. In addition, serum immune complex-like material was detected by sucrose densitygradient ultracentrifugation, standard anticomplementary assays, and radioimmunoassays using both C1q and monoclonal rheumatoid factor.

(Arch Dermatol 114:1177-1181, 1978)

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