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Vincent Falanga, MD; Thomas A. Medsger, Jr, MD; Morris Reichlin, MD

Arch Dermatol. 1987;123(3):350-353.

Abstract
• The clinical features of localized scleroderma have allowed investigators to distinguish three morphologic variants: morphea, generalized morphea, and linear scleroderma. The latter has been reported to have a higher frequency of antinuclear antibodies and has been associated with antibodies to single-stranded DNA (ssDNA). In this study we determined the frequency of antinuclear antibodies and anti-ssDNA antibodies in 22 patients with morphea or generalized morphea. None had Raynaud's phenomenon or evidence of a systemic connective-tissue disease. Antinuclear antibodies were present in 18% of patients when serum samples were tested on mouse kidney substrate but were found in 50% of HEp-2 cells. The serum samples contained anti-ssDNA antibodies in 59% of the patients, with the highest levels of ssDNA binding observed in patients with generalized morphea. The frequency of antibodies to ssDNA was higher in patients with clinical evidence of active compared with inactive disease. Discordance in immune reactivity indicates that at least three distinctive serum autoantibodies exist in morphea and generalized morphea: anti-ssDNA antibodies and antinuclear antibodies with either homogeneous or speckled immunofluorescence patterns. These findings are similar to those recently described in linear scleroderma and suggest that comparable serum autoantibody abnormalities are present in all the variants of localized scleroderma.

(Arch Dermatol 1987;123:350-353)

Author Affiliations
From the Department of Dermatology (Dr Falanga) and Division of Rheumatology and Clinical Immunology (Dr Medsger), University of Pittsburgh School of Medicine; and the Arthritis and Immunology Laboratory, Oklahoma Medical Research Foundation, Oklahoma City (Dr Reichlin). Dr Falanga is now with the Department of Dermatology and Cutaneous Surgery, University of Miami School of Medicine.

Footnotes
Accepted for publication May 22, 1986.

Reprint requests to Department of Dermatology and Cutaneous Surgery, University of Miami School of Medicine, PO Box 016250, Miami, FL 33101 (Dr Falanga).

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