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DIRECT IMMUNOFLUORESCENT STUDY OF SYSTEMIC LUPUS ERYTHEMATOSUS IN SINGAPORE *

The direct immunofluorescent antibody technique was employed in the study of 33 patients with systemic lupus erythematosus (SLE), 51 patients with miscellaneous dermatoses and 12 normal controls. Positive “band” test was found in 14 patients, 11 of whom had SLE. The “band” was observed in 41 per cent of SLE involved skin biopsies and 32 per cent of the SLE uninvolved skin biopsies. The major immune complex components in the eleven “band” positive SLE cases were, in order of frequency, IgM, IgG, complement (C3), IgA and fibrinogen. A majority (63.4 per cent) demonstrated the “homogenous” band pattern which was commonly associated with deposition of IgM and IgG. “Thready” band pattern was present in a third of the positive biopsies and was formed mainly by IgG and complement (C3). “Stippled” band pattern was seen in four biopsies only. “Band” positive patients had a higher incidence of systemic involvements and autoantibodies, and a poorer prognosis than the negative group. Comparisons are made of the above findings with those reported in other series. The results and other findings are then discussed.