Serologic and clinical data were obtained from forty patients with
discoid lupus erythematosus in 1982. Clinical disease was characterized by quality, extent, severity, activity, photosensitivity, and systemic manifestations. The patient's sera were examined for the presence of antinuclear, anti-Ro and anti-La, anti-
ribonucleoprotein and anti-Sm, anti-single-stranded
deoxyribonucleic acid (ssDNA), and antinative
DNA antibodies. In late 1984, thirty-three patients had follow-up clinical examinations. On the initial evaluation the patients with positive
antinuclear antibody (ANA) findings were clinically characterized by a significantly higher incidence of photosensitivity and
arthritis, an elevated erythrocyte sedimentation rate, and cutaneous lesions of subacute
cutaneous lupus erythematosus. The activity and extent of disease in 1982 did not correlate with the presence of ANA. Elevated levels of ssDNA
antibodies were present in seven of the forty patients (significantly greater than control subjects; (p less than 0.005) and correlated with widespread, active
discoid lupus erythematosus, an elevated erythrocyte sedimentation rate, and a slightly greater risk of
systemic lupus erythematosus in 1982. At the 2-year follow-up examination, thirteen of the seventeen patients with a positive ANA had active clinical cutaneous disease, and ten of the sixteen patients with negative ANA findings had continued activity (not statistically significant). However, all seven patients with elevated ssDNA antibody levels had continued activity, and
disease progression had occurred in three. Thus the presence of ssDNA seems to correlate strongly with active, progressive lupus erythematosus. The presence of antibody abnormalities in patients with
discoid lupus erythematosus correlates with clinical disease and provides more support for the theory linking
discoid lupus erythematosus to
systemic lupus erythematosus as part of a continuum.