Cutaneous Manifestations and Ana Profile in Various Connective Tissue Diseases

Abstract

BACKGROUND AND OBJECTIVES

Autoimmune connective tissue disorders have a vast array of cutaneous manifestations. A few manifestations are specific for the disease and few cutaneous manifestations can be seen overlapping with two diseases. The same is seen in the ANA study. An antinuclear antibody test often aids in the diagnosis as individual antibodies have various patterns seen on immunofluorescence. Therefore this is a cumulative study of all the connective tissue disorders, their cutaneous manifestations and ANA profile individually.

MATERIAL AND METHODS

A total of 50 patients diagnosed to have autoimmune connective tissue disease presenting with cutaneous manifestations were included in this study. All patients included underwent an ANA profile testing. All relevant investigations for the diagnosis of cutaneous and systemic illness were carried out.

RESULTS

At the end of the study, we found 81% of patients were females. Most patients were in their 3^rd to 5^th decade of life. The most common connective tissue disease presenting with cutaneous manifestations in our study was LE ( 40% ) followed by scleroderma ( 34% ), MCTD ( 10% ), RA ( 8% ), dermatomyositis ( 6% ) and overlap syndrome ( 2% ). Localised discoid plaque was seen in 75% of patients with CCLE, scarring alopecia was seen 41.7% of patients with CCLE and 83.3% of patients with SLE. The most common antibody positive was dsDNA. Expressionless face, bulbous fingers, digital pits and ulcer were seen in lesser number of patients with lcSSc when compared to dcSSc. Anti centromere was positive in 66.6% of patients having lcSSc and SCL-70 was positive in 100% of the patients with dcSSc. Calcinosis cutis and Rheumatoid nodules were seen in 25% of the RA patients. Other disease associations were also seen in these patients. Pathognomonic features like gottron papules were seen in all patients of dermatomyositis. Most patients of MCTD showed features of scleroderma. All patients of MCTD were positive for U1RNP antibody. One case of overlap syndrome was seen.

CONCLUSION

A patient with connective tissue disorder can present with varied cutaneous manifestations. Very often the cutaneous manifestations can be the only presenting complaint. Therefore a thorough knowledge of the various cutaneous manifestation, specific and non specific along with an ANA testing can help in early diagnosis of the disease, which intern will help in control of the disease and its varied severity.