การศึกษาความสัมพันธ์ของระดับการติดสีสารมิวซินในชิ้นเนื้อของผู้ป่วยโรคผื่นผิวหนังลูปัสอีริย์ธีมาโตซัส ชนิดดิสคอยด์ กับการเป็นการเป็นโรคลูปัสอีริย์ทีมาโตซัสทั่วร่างในโรงพยาบาลจุฬาลงกรณ์ สภากาชาดไทย / เบญจพร ศรีสันติธรรม = Association between quantity of dermal mucin in discoid lupus erythematosus patients and the diagnosis of systemic lupus erythematosus in King Chulalongkorn Memorial Hospital / Benjaporn Srisantithum
Background: Demal mucin is one of histiologic features making diagnosis of discoid lupus erythematosus (DLE). In pathophysilogy of DLE, acuumulation of dermal mucin might further perpetuate inflammation of lesions. However, the utility of dermal mucin as a prognostic factor to predict the development of systemic lupus erythematosus (SLE) in DLE patients has never been studied.Objectives: To study whether amount of dermal mucin can be a predictor of developing SLE in DLE patientsMethods: A cross-sectional study was conducted on 77 DLE lesions, histopathologically diagnosed from 2011 to 2017 at King Chulalongkorn Memorial Hospital. H&E, PAS and alcian blue staining were performed on tissue specimen to confirm the diagnosis and evaluate amount of dermal mucin from each compartment - papillary dermis, superficial reticular dermis and deep reticular dermis by scoring 0-3 (mucin score). After that medical records were reviewed about SLE status and lab investigations.Results: Among 77 DLE patients, 49 DLE-only, 8 DLE developing SLE, 5 SLE developing DLE and 15 SLE diagnosed simultaneously with DLE patients were documented. Between DLE-only and any SLE patients, mean and maximum of mucin score had no statistically significant association with the diagnosis of SLE in our DLE patients, after adjusted for gender and extent of lesions [OR=0.97 (95%CI0.49-1.92)] [OR=0.98 (95%CI0.6-1.58) respectively]. In each compartment, dermal mucin in papillary dermis [OR=0.7 (95%0.31-1.57)], superficial reticular dermis [OR=1.06 (95%CI0.62-1.85)] and deep reticular dermis [OR=1.04 (95%CI0.64-1.66)] had no statistical significance to diagnosed SLE in our DLE patients either. Positive staining of mucin in DLE had no statistical relevance with the diagnosis of SLE, after adjusted for gender and extent of lesions [OR=1.01 (95%CI0.31-3.32]. But between smoker and non-smoker DLE patients, mean of dermal mucin was statistically diffrent (p-value<0.05)Conclusions: Dermal mucin might not be used as prognostic marker to predict progressing of SLE from DLE. However, dermal mucin might involve in pathogenesis between DLE and smoking. Our study has small sample sizes, degeneration and unspecified locations of tissue specimens and short time to observe development of SLE from DLE as limitations
