Cutaneous vasculitis in systemic lupus erythematosus: association with anti-ribosomal P protein antibody and Raynaud phenomenon

Ninety-one consecutive systemic lupus erythematosus (SLE) patients (American College of Rheumatology criteria) with a history of cutaneous vasculitis were compared to 163 SLE controls without this clinical manifestation from July to December 2007 in order to determine the possible clinical and serological association of this manifestation. Data were obtained in an ongoing electronic database protocol and autoantibodies to anti-double-stranded DNA, anti-Sm, anti- RNP, anti-Ro/SS-A, anti-La/SS-B, and anticardiolipin and ribosomal P protein antibody (anti-P) were detected by standard techniques. Exclusion criteria were the presence of anti-phospholipid syndrome or antibodies, Sjِgren syndrome, and a history of thrombosis. The mean age (38.5±11.5 vs. 37.8±11.6 years, p=0.635), disease duration (12.5±7.8 vs. 11.8±7.9 years, p=0.501), and frequency of white race (71.4% vs. 70.5%, p=0.872) and female sex (96.8% vs. 93.7%, p=0.272) were comparable in both groups. The vasculitis group had a higher frequency of malar rash (97.9% vs. 87.4%, p=0.004), photosensitivity (91.4% vs. 81.6%, p=0.030), and Raynaud phenomenon (RP; 27.7% vs. 7.5%, p<0.001), whereas all other clinical manifestation including renal and central nervous system involvements were similar to the control group. Laboratorial data revealed that only anti-P (35.1% vs. 12.1%, p<0.001) was more frequent in patients with vasculitis. In a multivariate logistic regression model, cutaneous vasculitis was associated to the presence of RP (OR=3.70; 95% confidence interval [CI]=1.73–8.00) and anti-P (OR=3.42; 95% CI=1.76-6.66). In summary, SLE cutaneous vasculitis characterizes a subgroup of patients with more RP and anti-P antibodies but not accompanied by a higher frequency of renal and central nervous system involvements.