Posted by: Chris Maloney | February 17, 2012

Scleroderma, Lupus, and Autoimmune Skin Diseases: A Common Thread?

Lupus erythematosus

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When someone is diagnosed with an illness, they often have the illusion that the diagnosis will lead to an effective treatment.  In the case of something like a broken leg, this is true.  But in the case of many diseases, there is no effective conventional treatment.  Eventually some of those people find their way into alternative medicine, but most simply languish in a “just live with it” purgatory.

The percentage of those languishing with skin diseases is particularly high.  The treatment is overwhelmingly steroids, topical or oral.   This is true almost regardless of the diagnosis, and is only moderately effective in chronic illnesses.

Rather than continue to treat individual diagnoses, perhaps a systems approach will yield better results.  We need to group skin diseases by underlying pathology:  autoimmune, contact, environmental, systemic substance build up (like diabetes).  In that way we could pool research from various related illnesses and come up with better solutions for sufferers.  Here’s an example of that kind of research, showing a common thread between: systemic lupus erythematosus, scleroderma, pemphigus, bullous pemphigoid, dermatitis herpetiformis, psoriasis, contact dermatitis and lichen planus.  That’s right, very different diseases, but a common thread of what is happening in the tissue.  The genetic susceptibility affects how that disease manifests itself, but the underlying process is common.

We need few sub-specialties and more integration between specialties.  But unfortunately the grant funding structure for research is focused on individual diseases that were often categorized in the 1800’s and bear no relation to the commonality of cause.  It’s like someone in the 1800’s decided to name all the sheep different things.  So now we have black sheep researchers, and fluffy sheep researchers.   No one is looking at the fact that these are all sheep.

Here’s the abstract.

Ann Dermatol Venereol. 1981;108(10):741-9.

[Circulating immune complexes in skin disease patients. Study and literature data (author’s transl)]

[Article in French]

Guillot B, Guilhou JJ, Clot J, Meynadier J.

Abstract

Circulating immune complexes (C.I.C.) were investigated in 244 patients with various skin diseases and 100 healthy subjects. C.I.C. were detected by the PEG-C4 assay, firstly proposed by Digeon et al. using the precipitation by polyethylene glycol (PEG 3,5 p. 100) and the determination by laser nephelometry of complement component C4 in sera and in precipitates. The percentage of C4 precipitated and of positive subjects were significantly increased in numerous cutaneous diseases: systemic lupus erythematosus, scleroderma, pemphigus, bullous pemphigoid, dermatitis herpetiformis, psoriasis, contact dermatitis and lichen planus. Two cases of dermatomyositis, 3 cases of post herpetic erythema multiformis and 2 cases of Kaposi-Juliusberg syndroma were also positives but no definite conclusion can be given because of the few patients tested. On the contrary, the values of precipitated C4 are normal in most cases of atopic dermatitis (the method does not detect IgE-C.I.C.) scabies, porphyria cutanea tarda, cutaneous epithelioma and discoid lupus. In chronic urticaria and in mycosis fongoides the mean values of precipitated C4 are significantly increased but the number of positive subjects is low and the significance of these results is uncertain because of the wide range of the values. The results of the present study are compared with the literature data. The value of C.I.C. determination in determining the evolutivity of skin diseases and their possible role in pathogenesis are discussed.

PMID: 7305215

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