A 24 year old college student complains of fatigue, ahralgias, mucosal ulcerations, and a facial rash. Biopsy of the rash reveals linear deposition of IgG and complement at the dermal-epidermal junction. Which of the following is TRUE concerning this disease?
Onset of fatigue, ahralgias, mucosal ulcerations, and facial rash in a young person strongly suggests SLE. Additional features of SLE are low-grade fever, alopecia, pericarditis, ahritis, nephritis, nervous system involvement, and pleural effusions. Women are affected ten times more often than men. The lupus band test, demonstrating linear IgG and complement deposition at the dermal-epidermal junction, is positive in 90% of cases. However, it is not specific for SLE and may also be seen in bullous pemphigoid, dermatomyositis, and other autoimmune diseases. A positive reaction to the lupus band test on normal-appearing skin is helpful in diagnosis. Serum complement levels decline with disease flares and are useful in guiding treatment, whereas the ESR often remains elevated during remissions and is an unreliable marker of disease activity. Ref: Hellmann D.B., Imboden J.B. (2013). Chapter 20. Rheumatologic & Immunologic Disorders. In M.A. Papadakis, S.J. McPhee, M.W. Rabow (Eds),CURRENT Medical Diagnosis & Treatment 2013.
Women and men are equally affected
Skin biopsy findings are pathognomonic
Biopsy specimen of non-involved skin will be normal
Serum complement levels decrease with disease flares