Arch Dermatol
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Ten Ro(SS-A) antibody-positive patients with Sjögren's syndrome and lupus erythematosus are described. These patients have a disease process characterized by the frequent appearance of annular polycyclic lupus lesions of subacute cutaneous lupus erythematosus (SCLE), as well as neurologic and pulmonary disease. ⋯ These studies demonstrate that the patient with Ro(SS-A) antibody may exhibit a dynamic clinical disease expression over time and that there is a closer pathologic relationship between Sjögren's syndrome and SCLE in these patients with Ro(SS-A)-antibody than has previously been appreciated. Furthermore, Ro(SS-A)-positive patients with Sjögren's syndrome and lupus erythematosus appear to have a much more guarded prognosis than those Ro(SS-A)-positive lupus patients described under the classifications of antinuclear antibody-negative lupus erythematosus and SCLE.
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In a patient whose clinical features resembled subcorneal pustular dermatosis, IgA deposits in the intercellular space of the upper epidermis were found on direct immunofluorescence study. Furthermore, by indirect immunofluorescence, IgA autoantibodies against the same area of the epidermis were demonstrated in the patient's serum.
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Four patients with recurrent, periorbital basal cell carcinoma and who ultimately required craniofacial composite orbitectomies are presented. Common clinical features included medial canthal and eyelid location of tumors, multiple previous surgical procedures, and morphealike clinical appearance of the tumor. ⋯ This required an intracranial approach utilizing a frontal craniotomy and distant flap coverage of the resultant defect. Emphasis is placed on the early, aggressive, and complete surgical resection of such lesions, before orbital invasion has occurred, so subsequent mutilating surgery may be avoided.