Autoantibodies to Type VII Collagen May Precede the Development of Bullous Lupus Erythematosus

Jeffrey P. Callen, MD reviewing Grabell DA et al. JAMA Dermatol 2015 Feb 11.

These autoantibodies are probably linked to pathogenesis of this skin manifestation, but is routine testing necessary?

Bullous lupus erythematosus is associated with antibodies directed against type VII collagen. This skin manifestation is a rare variant and occurs in patients with known systemic lupus erythematosus (SLE). In a previous study of military recruits who developed SLE, it was demonstrated that various autoantibodies precede the development of clinical disease.

These authors conduct an ongoing study of patients with cutaneous lupus erythematosus and have been collecting and storing their sera. They were uniquely able, therefore, to examine the sera of a patient who developed bullous lupus erythematosus and to measure antibodies 3 months before the onset of clinical disease, at the time of diagnosis, and at a 12-month follow-up visit. They found that antibodies to type VII collagen were present 3 months before symptom onset and that the titer rose at the time of diagnosis and fell during follow-up, when clinical disease was absent.

Citation(s):

Grabell DA et al. Detection of type VII collagen autoantibodies before the onset of bullous systemic lupus erythematosus. JAMA Dermatol 2015 Feb 11; [e-pub].