A patient with subacute cutaneous lupus erythematosus (SCLE) has annular polycyclic lesions on the upper back. The antibody most specifically associated with SCLE is:

• A Anti-dsDNA
• B Anti-Smith (Sm) antibody
• C Anti-histone antibody
• D Anti-Ro/SSA antibody ✓

Explanation

Anti-Ro/SSA antibodies are present in 70–80% of SCLE patients and are the antibody most specifically associated with this subtype. SCLE is photosensitive, non-scarring, and presents in two morphological forms: papulosquamous (psoriasiform) and annular-polycyclic. DIF of lesional skin in SCLE (and discoid LE) shows IgG/IgM deposits at the DEJ (lupus band). Anti-dsDNA and anti-Sm are more specific for systemic SLE with renal involvement. Anti-histone antibodies are associated with drug-induced lupus.

Reference: Neena Khanna Illustrated Synopsis of Dermatology & STD, 6th ed.

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