{"title":"皮肤病学和免疫学的交叉学科：结缔组织疾病的皮肤表现、自身抗体和生活质量。","authors":"S W Lai, L Selvarajah","doi":"","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Connective tissue diseases (CTDs) are autoimmune diseases with multiorgan involvement. CTDs present with a heterogeneous clinical manifestation, especially in the cutaneous system. This study aimed to describe the common cutaneous manifestations of CTDs, to determine the association with antinuclear antibody (ANA) and other associated antibodies, and to assess the impact of CTDs on patient's quality of life (QOL).</p><p><strong>Material and methods: </strong>This was a cross-sectional study conducted among patients 18 years and above, with a confirmed diagnosis of systemic lupus erythematosus (SLE), systemic sclerosis, dermatomyositis, mixed connective tissue disease (MCTD) or overlap syndrome, who attended the rheumatology clinic at Hospital Sultan Ismail Johor Bahru between March 2023 to June 2023. The assessment instrument used was the Dermatology Quality Life Index (DLQI).</p><p><strong>Results: </strong>Among 79 patients recruited, the majority were females with a mean age of 39 ± 14.5 years. Malay was the predominant ethnic group. SLE was the most common CTD (64 patients, 81%), followed by systemic sclerosis (six patients, 7.6%), overlap syndrome (four patients, 5.1%), dermatomyositis (four patients, 5.1%) and MCTD (one patient, 1.3%). All patients had cutaneous involvement with photodermatitis being the commonest cutaneous manifestation (65 patients, 82.3%). ANA and anti-double stranded DNA (dsDNA) positivity were significantly associated with SLE while anti-scl70 and anti-centromere antibodies (ACA) were strongly associated with systemic sclerosis (p < 0.05). The presence of anti-dsDNA and antiscl70 were significantly associated with renal involvement and interstitial lung disease (ILD) respectively (p < 0.05). CTD had a moderate effect on patient's QOL.</p><p><strong>Conclusion: </strong>Photosensitivity was the commonest cutaneous manifestation among CTD patients. ANA was positive in the majority of SLE patients. The presence of anti-dsDNA was significantly associated with lupus nephritis, while anti-scl70 and ACA were strongly associated with systemic sclerosis and ILD. CTD had a moderate effect on patient's QOL.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"79 5","pages":"597-603"},"PeriodicalIF":0.0000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The intersection of dermatology and immunology: Cutaneous manifestations, autoantibodies and quality of life in connective tissue diseases.\",\"authors\":\"S W Lai, L Selvarajah\",\"doi\":\"\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Connective tissue diseases (CTDs) are autoimmune diseases with multiorgan involvement. CTDs present with a heterogeneous clinical manifestation, especially in the cutaneous system. This study aimed to describe the common cutaneous manifestations of CTDs, to determine the association with antinuclear antibody (ANA) and other associated antibodies, and to assess the impact of CTDs on patient's quality of life (QOL).</p><p><strong>Material and methods: </strong>This was a cross-sectional study conducted among patients 18 years and above, with a confirmed diagnosis of systemic lupus erythematosus (SLE), systemic sclerosis, dermatomyositis, mixed connective tissue disease (MCTD) or overlap syndrome, who attended the rheumatology clinic at Hospital Sultan Ismail Johor Bahru between March 2023 to June 2023. The assessment instrument used was the Dermatology Quality Life Index (DLQI).</p><p><strong>Results: </strong>Among 79 patients recruited, the majority were females with a mean age of 39 ± 14.5 years. Malay was the predominant ethnic group. SLE was the most common CTD (64 patients, 81%), followed by systemic sclerosis (six patients, 7.6%), overlap syndrome (four patients, 5.1%), dermatomyositis (four patients, 5.1%) and MCTD (one patient, 1.3%). All patients had cutaneous involvement with photodermatitis being the commonest cutaneous manifestation (65 patients, 82.3%). ANA and anti-double stranded DNA (dsDNA) positivity were significantly associated with SLE while anti-scl70 and anti-centromere antibodies (ACA) were strongly associated with systemic sclerosis (p < 0.05). The presence of anti-dsDNA and antiscl70 were significantly associated with renal involvement and interstitial lung disease (ILD) respectively (p < 0.05). CTD had a moderate effect on patient's QOL.</p><p><strong>Conclusion: </strong>Photosensitivity was the commonest cutaneous manifestation among CTD patients. ANA was positive in the majority of SLE patients. The presence of anti-dsDNA was significantly associated with lupus nephritis, while anti-scl70 and ACA were strongly associated with systemic sclerosis and ILD. CTD had a moderate effect on patient's QOL.</p>\",\"PeriodicalId\":39388,\"journal\":{\"name\":\"Medical Journal of Malaysia\",\"volume\":\"79 5\",\"pages\":\"597-603\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Medical Journal of Malaysia\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Medical Journal of Malaysia","FirstCategoryId":"1085","ListUrlMain":"","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
The intersection of dermatology and immunology: Cutaneous manifestations, autoantibodies and quality of life in connective tissue diseases.
Introduction: Connective tissue diseases (CTDs) are autoimmune diseases with multiorgan involvement. CTDs present with a heterogeneous clinical manifestation, especially in the cutaneous system. This study aimed to describe the common cutaneous manifestations of CTDs, to determine the association with antinuclear antibody (ANA) and other associated antibodies, and to assess the impact of CTDs on patient's quality of life (QOL).
Material and methods: This was a cross-sectional study conducted among patients 18 years and above, with a confirmed diagnosis of systemic lupus erythematosus (SLE), systemic sclerosis, dermatomyositis, mixed connective tissue disease (MCTD) or overlap syndrome, who attended the rheumatology clinic at Hospital Sultan Ismail Johor Bahru between March 2023 to June 2023. The assessment instrument used was the Dermatology Quality Life Index (DLQI).
Results: Among 79 patients recruited, the majority were females with a mean age of 39 ± 14.5 years. Malay was the predominant ethnic group. SLE was the most common CTD (64 patients, 81%), followed by systemic sclerosis (six patients, 7.6%), overlap syndrome (four patients, 5.1%), dermatomyositis (four patients, 5.1%) and MCTD (one patient, 1.3%). All patients had cutaneous involvement with photodermatitis being the commonest cutaneous manifestation (65 patients, 82.3%). ANA and anti-double stranded DNA (dsDNA) positivity were significantly associated with SLE while anti-scl70 and anti-centromere antibodies (ACA) were strongly associated with systemic sclerosis (p < 0.05). The presence of anti-dsDNA and antiscl70 were significantly associated with renal involvement and interstitial lung disease (ILD) respectively (p < 0.05). CTD had a moderate effect on patient's QOL.
Conclusion: Photosensitivity was the commonest cutaneous manifestation among CTD patients. ANA was positive in the majority of SLE patients. The presence of anti-dsDNA was significantly associated with lupus nephritis, while anti-scl70 and ACA were strongly associated with systemic sclerosis and ILD. CTD had a moderate effect on patient's QOL.
期刊介绍：
Published since 1890 this journal originated as the Journal of the Straits Medical Association. With the formation of the Malaysian Medical Association (MMA), the Journal became the official organ, supervised by an editorial board. Some of the early Hon. Editors were Mr. H.M. McGladdery (1960 - 1964), Dr. A.A. Sandosham (1965 - 1977), Prof. Paul C.Y. Chen (1977 - 1987). It is a scientific journal, published quarterly and can be found in medical libraries in many parts of the world. The Journal also enjoys the status of being listed in the Index Medicus, the internationally accepted reference index of medical journals. The editorial columns often reflect the Association''s views and attitudes towards medical problems in the country. The MJM aims to be a peer reviewed scientific journal of the highest quality. We want to ensure that whatever data is published is true and any opinion expressed important to medical science. We believe being Malaysian is our unique niche; our priority will be for scientific knowledge about diseases found in Malaysia and for the practice of medicine in Malaysia. The MJM will archive knowledge about the changing pattern of human diseases and our endeavours to overcome them. It will also document how medicine develops as a profession in the nation. We will communicate and co-operate with other scientific journals in Malaysia. We seek articles that are of educational value to doctors. We will consider all unsolicited articles submitted to the journal and will commission distinguished Malaysians to write relevant review articles. We want to help doctors make better decisions and be good at judging the value of scientific data. We want to help doctors write better, to be articulate and precise.
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