The gender disparity of immunoreactants in lesional skin of lupus erythematosus patients

The immunoreactants detected by direct immunofluorescence (DIF) from the skin of patients with lupus erythematosus (LE) were related to disease subtypes and skin morphology. Male patients presented more frequently with discoid rashes and females with malar rashes. We investigated the differences in immunoreactants in skin lesions between male and female LE patients. The DIF records of 186 LE patients were reviewed and analysed. Among 186 patients (133 female and 53 male), 54 had cutaneous LE (CLE) and 132 had systemic LE (SLE). In the CLE group, eight of 33 (24.2%) women were DIF+ versus nine of 21(42.9%) men (p=0.23). In the SLE group, 49 of 100 (49%) women were DIF+ versus 17 of 32 (53.1%) men (p=0.84). The p-value was 0.01 when comparing DIF incidence between female CLE and SLE patients. IgM and complement component 3 (C3) were present in 84.2% and 52.6% of DIF+female patients, respectively, and both were comparable between genders (p>0.05). However, IgG was observed only in eight of 57 female patients, and in 10 of 26 male patients (p=0.02). Among DIF+CLE patients, IgG was detected in none of the eight female versus three of nine male patients. Detection of immunoreactants in skin had no gender bias in CLE or SLE, but among women, it was probably lower in CLE than SLE. IgM and C3 were the most frequent immunoreactants in skin with no gender disparity, whereas IgG in female patients was lower than in males.