The lupus band test in systemic lupus erythematosus patients

Abstract

The lupus band test (LBT) is a diagnostic procedure that is used to detect deposits of immunoglobulins and complement components along the dermoepidermal junction in patients with lupus erythematosus (LE). The LBT is positive in about 70%–80% of sun-exposed non-lesional skin specimens obtained from patients with systemic LE (SLE), and in about 55% of SLE cases if sun-protected nonlesional skin is analyzed. In patients with cutaneous LE only, the lesional skin usually shows a positive LBT. The LBT helps in differentiating LE from other similar skin conditions and may also be helpful in making the diagnosis of SLE in subjects with no specific cutaneous lesions. Furthermore, a positive LBT may be applied as a prognostic parameter for LE patients. However, the correct interpretation of this test requires detailed knowledge of the site of the biopsy, deposit components, morphology and brightness of the immunofluorescent band, and other associated serologic findings, as well as the response to treatment. It must be emphasized that LBT is a laboratory procedure that should always be interpreted in conjunction with clinical findings and other serological and immunopathological parameters.

Correlation of Cutaneous Immunoreactants in Lesional Skin with the Serological Disorders and Disease Activity of Systemic Lupus Erythematosus

“…In the present study, the common feature was observed as a continuous fluorescent band with moderate to marked intensity consisting multiple bright dots or clumps, consistent with previous report [4]. For single immunoreactant deposition, the staining pattern varied among individual samples.…”

“…The staining pattern of immunoreactants in lesional and non-lesional skin of lupus patients were thoroughly discussed by Reich A et al [4]. In the present study, the common feature was observed as a continuous fluorescent band with moderate to marked intensity consisting multiple bright dots or clumps, consistent with previous report [4].…”

“…Clinically, the presence of a skin rash is important as it is one of the earliest symptoms that patients report [1]. Diagnosis of lupus lesions in patients with skin rashes is determined by a clinical test using direct immunofluorescence (DIF) to detect immunoreactants, most commonly immunoglobulin G (IgG), IgM, IgA, and complement component 3 (C3), along the dermal-epidermal junction [2]–[4].…”

IgA vasculitis (formerly Henoch-Schönlein purpura) in an adult with systemic lupus erythematosus

“…A skin biopsy revealed leucocytoclastic vasculitis. Immunohistochemistry staining revealed linear deposits of IgG and C3 along the dermoepidermal transition (typical finding in patients with SLE), as well as IgA deposits on superficial dermal capillaries 2. IgA vasculitis was then assumed, without lupus flare or increased SLE activity.…”

Comparative Study of Direct Immunofluorescence in Discoid Lupus Erythematosus and Bullous Pemphigoid

“…1 Lupus band test (LBT) should be considered positive when deposition of IgM in sun-exposed skin forms a continuous band over at least 50% of the width of the biopsy specimen, which shows at least moderate intensity. 2 The pattern of the deposition is typically as granules or closely spaced fibrils. 3 In the previous study, LBT of DLE demonstrated depositions of IgG (58%), IgA (38%), IgM (78%), and C3 (72%).…”