Deposition of membrane attack complex in cutaneous lesions of lupus erythematosus

• Published in: Journal of the American Academy of Dermatology Vol. 28; no. 5; pp. 687 - 691
• Main Authors: Helm, Klaus F., Peters, Margot S.
• Format: Journal Article Conference Proceeding
• Language: English
• Published: New York, NY Mosby, Inc 01.05.1993; Elsevier
• Subjects: Basement Membrane - metabolism; Basement Membrane - pathology; Biological and medical sciences; Complement C3 - metabolism; Complement Membrane Attack Complex - metabolism; Fluorescent Antibody Technique; Humans; Immunoglobulin A - metabolism; Immunoglobulin G - metabolism; Immunoglobulin M - metabolism; Lupus Erythematosus, Cutaneous - metabolism; Lupus Erythematosus, Cutaneous - pathology; Lupus Erythematosus, Discoid - metabolism; Lupus Erythematosus, Discoid - pathology; Lupus Erythematosus, Systemic - metabolism; Lupus Erythematosus, Systemic - pathology; Medical sciences; Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis; Sensitivity and Specificity; Skin - metabolism; Skin - pathology; Staining and Labeling; Performance evaluation; Human; Connective tissue disease; Skin disease; Exploration; Complement; Basement membrane; Systemic disease; Lupus erythematosus; Membrane attack complex; Skin; Diagnosis; Immunofluorescence
• ISSN: 0190-9622; 1097-6787
• DOI: 10.1016/0190-9622(93)70093-9

Background : The membrane attack complex (MAC; C5b-9) localizes in the basement membrane zone (BMZ) of cutaneous lesions from patients with lupus erythematosus (LE) and has been implicated in the pathogenesis of this disease. Objective : Our purpose was to compare the frequency of MAC deposition with that of immunoglobulin and C3 deposition (lupus band). Methods : We studied 56 skin biopsy specimens from 42 patients with LE by direct immunofluorescence. Results : MAC was deposited in a granular pattern at the BMZ in 29 of 38 biopsy specimens (76%) from lesional skin; 5 of 38 specimens (13%) had focal or weak segmental deposition and 4 of 38 (11 %) were negative. In contrast, IgG, IgM, IgA, and C3 were detected in 16 of 38 specimens (42%), 30 of 38 (79%), 4 of 38 (11%), and 22 of 38 (58%), respectively. None of the uninvolved skin biopsy specimens was MAC positive, although 4 of 18 (22%), 5 of 18 (28%), 1 of 18 (6%), and 2 of 18 (11%) were positive for IgG, IgM, IgA, and C3, respectively. Conclusion : MAC deposition in lesional skin appears to be a relatively sensitive and specific marker for cutaneous LE and may be useful as an adjunct to the “lupus band” test.