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Antinuclear Antibodies and PUVA Photochemotherapy

Antinuclear Antibodies and PUVA Photochemotherapy Abstract • Sequential testing for antinuclear antibody (ANA) in a group of 99 patients receiving long-term methoxsalen (PUVA [methoxsalen plus ultraviolet light]) therapy showed positive tests for ANA in the serum samples of 42 patients. In 22 patients, the ANA was persistent; in seven patients, it was transient; and in the other 13 patients, it developed near the end of the observation period. A causal association between the occurrence of ANA and PUVA therapy is suggested by the incidence of ANA, its conversion from a negative to positive ANA test in 31 of 42 patients, and its statistically significant correlation with the duration of PUVA therapy. The ANA titers were 1:80 or greater in only 12 patients. The staining pattern was homogeneous in 39 patients, speckled in two patients, and nucleolar in one patient. In patients with a positive ANA test, the serologic tests for antibodies to DNA and extractable nuclear antigens were negative. Patients with positive ANA tests were significantly older than patients with negative ANA tests. Symptomatic systemic disease has not developed in any patient with a positive ANA test in this group. (Arch Dermatol 1981;117:474-477) References 1. Hughes CRV, Lachman PJ: Systemic lupus erythematosus , in Gell PGH, Coombs RRA, Lachman PJ (eds): Clinical Aspects of Immunology , ed 3. London, Blackwell Scientific Publications, 1975, p 1122. 2. Hooper B, Whittingham S, Matthews JD, et al: Autoimmunity in a rural community . Clin Exp Immunol 1972;12:79. 3. Cammarata RJ, Rodnan GP, Fennell RH: Serum anti-γ-globulin and antinuclear factors in the aged . JAMA 1967;199:455-463.Crossref 4. Lee SL, Chase HP: Drug induced systemic lupus erythematosus: A critical review . Semin Arthritis Rheum 1975;53:83-103.Crossref 5. Grabar P: ` Self' and `not-self' in immunology . Lancet 1974;1:1320-1322.Crossref 6. Pathak MA, Kramer D: Photosensitization of skin in vivo by furocoumarins (psoralen) . Arch Biochem Biophys 1969;195:197-206. 7. Parish JA, Fitzpatrick TB, Tanenbaum L, et al: Photochemotherapy of psoriasis with oral methoxsalen and longwave ultraviolet light . N Engl J Med 1974;291:1207-1211.Crossref 8. Wolff F, Fitzpatrick TB, Parish JA, et al: Photochemotherapy for psoriasis with orally administered methoxsalen . Arch Dermatol 1976;112:943-950.Crossref 9. Gilchrest BA, Parish JA, Tanenbaum L, et al: Oral methoxsalen photochemotherapy of mycosis fungoides . Cancer 1976;38:683-689.Crossref 10. Roenigk HH Jr: Photochemotherapy for mycosis fungoides . Arch Dermatol 1977;113:1047-1051.Crossref 11. Kubba R, Steck WD: Antinuclear antibodies associated with PUVA therapy , abstracted. Clin Res 1978;26:572. 12. Current status for oral PUVA therapy . J Am Acad Dermatol 1979;1:106-117.Crossref 13. Rothfield NF: Detection of antibodies to nuclear antigens by immunofluorescence , in Rose NR, Friedman H (eds): Manual of Clinical Immunology . Washington, DC, American Society for Microbiology, 1976, p 647. 14. Pincus T, Schur PH, Rose JA, et al: Measurement of serum DNA-binding activity in systemic lupus erythematosus . N Engl J Med 1969;281:701-705.Crossref 15. Kurata N, Tan EM: Identification of antibodies to nuclear acidic antigens by counterimmunoelectrophoresis . Arthritis Rheum 1970;19:574-580.Crossref 16. Epstein W: Immunologic factors in psoriasis , in Farber EM, Cox AJ (eds): Psoriasis: Proceedings of the International Symposium , Stanford. New York, Yorke Medical Books, 1971, p 298. 17. Lambert JR, Scott G, Wright V: Psoriatic arthritis and antinuclear factor . Br J Dermatol 1977;96:11-14.Crossref 18. Bjellerup M, Bruze M, Forsgren A, et al: Antinuclear antibodies during PUVA therapy . Acta Derm Venereol 1979;59:73-75. 19. Stern RS, Morison WL, Thibodeau LA, et al: Antinuclear antibodies and oral methoxsalen photochemotherapy (PUVA) for psoriasis . Arch Dermatol 1979;115:1320-1324.Crossref 20. Wolff K, Gschnait F, Honigsmann H, et al: Oral photochemotherapy results, follow-up and pathology , in Farber EM, Cox AJ (eds): Psoriasis: Proceedings of the Second International Symposium . New York, Yorke Medical Books, 1976, pp 300-309. 21. Eyanson S, Griest MC, Brandt KD, et al: Systemic lupus erythematosus: Association with psoralen-ultraviolet—a treatment of psoriasis . Arch Dermatol 1979;115:54-56.Crossref 22. Millns JL, McDuffie FC, Muller SA, et al: Development of photosensitivity and an SLE-like syndrome in a patient with psoriasis . Arch Dermatol 1978;114:1177-1181.Crossref 23. Rothfield NF, Bierer WF, Garfield JW: The induction of antinuclear antibodies by isoniazid: A prospective study . Arthritis Rheum 1971;14:182-183. 24. Tan EM, Stoughton RB: Ultraviolet light alteration of cellular deoxyribonucleic acid in vivo . Proc Natl Acad Sci USA 1969;52:708-714.Crossref 25. Davis P: Antibodies to UV-DNA and photosensitivity . Br J Dermatol 1977;97:197-200.Crossref 26. Zarelska Z, Jarzabek-Chorzelska M, Rzesa G, et al: Antigenicity of DNA induced by photoaddition of 8-methoxypsoralen . Photochem Photobiol 1978;27:37-42.Crossref 27. Blomgren SE, Vaughan JH: The immunogenicity of photooxidized DNA and of the photoproduct of DNA and procainamide hydrochloride . Arthritis Rheum 1968;11:470. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Dermatology American Medical Association

Antinuclear Antibodies and PUVA Photochemotherapy

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References (30)

Publisher
American Medical Association
Copyright
Copyright © 1981 American Medical Association. All Rights Reserved.
ISSN
0003-987X
eISSN
1538-3652
DOI
10.1001/archderm.1981.01650080028022
Publisher site
See Article on Publisher Site

Abstract

Abstract • Sequential testing for antinuclear antibody (ANA) in a group of 99 patients receiving long-term methoxsalen (PUVA [methoxsalen plus ultraviolet light]) therapy showed positive tests for ANA in the serum samples of 42 patients. In 22 patients, the ANA was persistent; in seven patients, it was transient; and in the other 13 patients, it developed near the end of the observation period. A causal association between the occurrence of ANA and PUVA therapy is suggested by the incidence of ANA, its conversion from a negative to positive ANA test in 31 of 42 patients, and its statistically significant correlation with the duration of PUVA therapy. The ANA titers were 1:80 or greater in only 12 patients. The staining pattern was homogeneous in 39 patients, speckled in two patients, and nucleolar in one patient. In patients with a positive ANA test, the serologic tests for antibodies to DNA and extractable nuclear antigens were negative. Patients with positive ANA tests were significantly older than patients with negative ANA tests. Symptomatic systemic disease has not developed in any patient with a positive ANA test in this group. (Arch Dermatol 1981;117:474-477) References 1. Hughes CRV, Lachman PJ: Systemic lupus erythematosus , in Gell PGH, Coombs RRA, Lachman PJ (eds): Clinical Aspects of Immunology , ed 3. London, Blackwell Scientific Publications, 1975, p 1122. 2. Hooper B, Whittingham S, Matthews JD, et al: Autoimmunity in a rural community . Clin Exp Immunol 1972;12:79. 3. Cammarata RJ, Rodnan GP, Fennell RH: Serum anti-γ-globulin and antinuclear factors in the aged . JAMA 1967;199:455-463.Crossref 4. Lee SL, Chase HP: Drug induced systemic lupus erythematosus: A critical review . Semin Arthritis Rheum 1975;53:83-103.Crossref 5. Grabar P: ` Self' and `not-self' in immunology . Lancet 1974;1:1320-1322.Crossref 6. Pathak MA, Kramer D: Photosensitization of skin in vivo by furocoumarins (psoralen) . Arch Biochem Biophys 1969;195:197-206. 7. Parish JA, Fitzpatrick TB, Tanenbaum L, et al: Photochemotherapy of psoriasis with oral methoxsalen and longwave ultraviolet light . N Engl J Med 1974;291:1207-1211.Crossref 8. Wolff F, Fitzpatrick TB, Parish JA, et al: Photochemotherapy for psoriasis with orally administered methoxsalen . Arch Dermatol 1976;112:943-950.Crossref 9. Gilchrest BA, Parish JA, Tanenbaum L, et al: Oral methoxsalen photochemotherapy of mycosis fungoides . Cancer 1976;38:683-689.Crossref 10. Roenigk HH Jr: Photochemotherapy for mycosis fungoides . Arch Dermatol 1977;113:1047-1051.Crossref 11. Kubba R, Steck WD: Antinuclear antibodies associated with PUVA therapy , abstracted. Clin Res 1978;26:572. 12. Current status for oral PUVA therapy . J Am Acad Dermatol 1979;1:106-117.Crossref 13. Rothfield NF: Detection of antibodies to nuclear antigens by immunofluorescence , in Rose NR, Friedman H (eds): Manual of Clinical Immunology . Washington, DC, American Society for Microbiology, 1976, p 647. 14. Pincus T, Schur PH, Rose JA, et al: Measurement of serum DNA-binding activity in systemic lupus erythematosus . N Engl J Med 1969;281:701-705.Crossref 15. Kurata N, Tan EM: Identification of antibodies to nuclear acidic antigens by counterimmunoelectrophoresis . Arthritis Rheum 1970;19:574-580.Crossref 16. Epstein W: Immunologic factors in psoriasis , in Farber EM, Cox AJ (eds): Psoriasis: Proceedings of the International Symposium , Stanford. New York, Yorke Medical Books, 1971, p 298. 17. Lambert JR, Scott G, Wright V: Psoriatic arthritis and antinuclear factor . Br J Dermatol 1977;96:11-14.Crossref 18. Bjellerup M, Bruze M, Forsgren A, et al: Antinuclear antibodies during PUVA therapy . Acta Derm Venereol 1979;59:73-75. 19. Stern RS, Morison WL, Thibodeau LA, et al: Antinuclear antibodies and oral methoxsalen photochemotherapy (PUVA) for psoriasis . Arch Dermatol 1979;115:1320-1324.Crossref 20. Wolff K, Gschnait F, Honigsmann H, et al: Oral photochemotherapy results, follow-up and pathology , in Farber EM, Cox AJ (eds): Psoriasis: Proceedings of the Second International Symposium . New York, Yorke Medical Books, 1976, pp 300-309. 21. Eyanson S, Griest MC, Brandt KD, et al: Systemic lupus erythematosus: Association with psoralen-ultraviolet—a treatment of psoriasis . Arch Dermatol 1979;115:54-56.Crossref 22. Millns JL, McDuffie FC, Muller SA, et al: Development of photosensitivity and an SLE-like syndrome in a patient with psoriasis . Arch Dermatol 1978;114:1177-1181.Crossref 23. Rothfield NF, Bierer WF, Garfield JW: The induction of antinuclear antibodies by isoniazid: A prospective study . Arthritis Rheum 1971;14:182-183. 24. Tan EM, Stoughton RB: Ultraviolet light alteration of cellular deoxyribonucleic acid in vivo . Proc Natl Acad Sci USA 1969;52:708-714.Crossref 25. Davis P: Antibodies to UV-DNA and photosensitivity . Br J Dermatol 1977;97:197-200.Crossref 26. Zarelska Z, Jarzabek-Chorzelska M, Rzesa G, et al: Antigenicity of DNA induced by photoaddition of 8-methoxypsoralen . Photochem Photobiol 1978;27:37-42.Crossref 27. Blomgren SE, Vaughan JH: The immunogenicity of photooxidized DNA and of the photoproduct of DNA and procainamide hydrochloride . Arthritis Rheum 1968;11:470.

Journal

Archives of DermatologyAmerican Medical Association

Published: Aug 1, 1981

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