[Anticardiolipin antibodies in cutaneous lupus erythematosus. Incidence and importance as a marker of vascular symptoms].

In 67 patients with lupus erythematosus (LE), 33 patients with the chronic discoid type (CDLE), 22 with the subacute cutaneous type (SCLE) and 12 with systemic LE (SLE), the presence of circulating anticardiolipin antibodies (ACA) of the IgG and IgM isotypes was investigated with an enzyme immunoassay (ELISA). ACA of the IgG isotype were found in 13 patients (= 39.4%) with CDLE and ACA-IgM in 5 other cases (= 15.2%); among the SCLE patients ACA-IgG was increased in 8 (= 36.4%) and ACA-IgM in 1 other (= 4.5%), while in 3 further patients (= 13.6%) both ACA-IgG and IgM were detected. In total, ACA were found in 54.6% of the CDLE and in 54.5% of the SCLE patients. In SLE ACA-IgG alone was seen in 41.7% of the patients and ACA of both isotypes in another 33.3%. The serum levels of ACA were higher in SLE than in the cutaneous LE subsets. No correlation with the presence of ANA and binding capacity was detected in any of these groups. Vascular symptoms were seen in 19 of 39 patients with detectable ACA (= 48.7%), whereas only 9 of 27 ACA-negative patients (= 33.3%) were found to have vascular symptoms on clinical examination. Only 1 of the patients with isolated ACA-IgM elevation (5 CDLE patients, 1 SCLE patient) had vascular symptoms. The detection of circulating ACA is a non-specific but rather sensitive marker for cutaneous LE. In particular, the ACA-IgG isotype shows a statistical correlation with the presence of vascular symptoms and is useful as a complement to the immune serological tests for the diagnosis of LE.