Immunologic Abnormalities Associated With Primary Anetoderma

Abstract

These findings indicate that there is an immunologic involvement in primary anetoderma.

Primary Anetoderma and Antiphospholipid Antibodies—Review of the Literature

“…In all clinical and/or laboratory, immunologic abnormalities were found: one with Graves' disease, lupus anticoagulant and autoimmune hemolysis; one had systemic scleroderma; most had positive direct immunofluorescence findings; all had serologic immunologic abnormalities, of which the most common was ANA. On the basis of this series of patients and the previously reported cases, together with the finding that in all PA specimens there was a lymphocytic infiltrate with a predominance of helper T-cells [25], we suggested that PA is not primary or idiopathic at all, but rather, represents a rare elastolytic disorder in which immunologic mechanisms are involved [24].…”

“…They concluded that PA is more often associated with aPL-positive SLE or aPL-positive lupus-like disease than with aPL-negative disease. Conversely, in two studies on a series of unselected PA patients, one by us in 1992 [24], the other by Stephansson et al in 1995 [29], a rare occurrence of aPL was found. However, the serologic tests employed to detect aPL in these two studies were of limited scope: LAC and VDRL in the first report [24], and in the other, also aCL isotypes G and M [29].…”

“…Most of these patients, in addition, showed various serologic abnormalities, including ANA, anti-n-DNA, LE cells, hypocomplementemia, biologic false positive test for syphilis, rheumatoid factor, and elevated levels of serum immunoglobulins. In an attempt to determine whether these early observations regarding the association of PA with clinical and/or immunologic findings were more than coincidental, in 1992, we studied six consecutive patients with this rare disorder [24]. In all clinical and/or laboratory, immunologic abnormalities were found: one with Graves' disease, lupus anticoagulant and autoimmune hemolysis; one had systemic scleroderma; most had positive direct immunofluorescence findings; all had serologic immunologic abnormalities, of which the most common was ANA.…”

Acquired disorders of elastic tissue: Part II. decreased elastic tissue

“…23 Associated conditions. Secondary anetoderma has been associated with urticaria pigmentosa, 24 syphilis, 25 acne, 26 varicella, 27 Lyme disease, 28 leprosy, 29 HIV infection, 30,31 lymphoproliferative disorders, 32,33 Langerhans cell histiocytosis, 34 systemic lupus erythematosus, 14,35,36 primary hypothyroidism, 37 Graves disease, 38 Addison disease, 14 antiphospholipid syndrome, 39 Sjögren syndrome, 40 prurigo nodularis, 41 pilomatricoma, 42,43 application of leeches, 44 electrocardiographic lead placement, 45 hepatitis B vaccination, 46 chronic angular cheilitis, 47 congenital melanocytic nevi with hamartomatous features, 48 juvenile xanthogranuloma, 49 and generalized granuloma annulare. 50 Involvement of extracutaneous elastic tissue has not been reported.…”

Anetoderma in systemic lupus erythematosus: relationship to antiphospholipid antibodies

“…4 Also suggestive of such a role have been associations with lepromatous leprosy, with acrodermatitis chronica, a proven borreliosis, 1,5 or with positive clinical, serologic andaor immuno¯uorescent ®ndings of an associated autoimmune disease (secondary anetoderma). 6,7 Occurrence of anetoderma in patients with systemic lupus erythematosus (SLE), 8 particularly when positive for antiphospholipid antibodies (aPL), 8,9 has been recorded, mostly in the dermatological literature. Cutaneous microthromboses have been proposed to explain this association.…”