Anti-SSA/Ro antibody as a risk factor for fluorouracil-induced drug eruptions showing acral erythema and discoid-lupus-erythematosus-like lesions

Background: It is well known that fluorouracil (FU) agents frequently induce discoid-lupus-erythematosus (DLE)-like eruptions and acral erythema in Japan. However, the etiology of these drug eruptions caused by FU agents has not been clarified yet. Objective: To determine if the existence of anti-SSA/Ro antibody may be a risk factor for FU-agent-induced DLE-like eruptions and acral erythema. Patients and Methods: Six patients with FU-agent-induced drug eruptions showing DLE-like lesions and acral erythema were enrolled in this study. The titers of anti-SSA/Ro antibody in the sera and the histopathology of the skin lesions were examined. Results: Biopsy specimens from DLE-like eruptions and all 5 examined acral erythema cases showed lichenoid change of the basal keratinocytes. Direct immunofluorescence studies revealed deposition of immunoglobulins along the basement membrane zone in the lesions of both DLE-like eruptions and acral erythema. Further, all 6 cases had high titers of serum anti-SSA/Ro antibody, which did not decline within 6 months after cessation of the causative drug. Conclusion: We propose that anti-SSA/Ro antibody may be a risk factor for FU-agent-induced drug eruptions showing acral erythema and DLE-like eruptions. Copyright (c) 2007 S. Karger AG, Basel.