Early events in ultraviolet light-induced skin lesions in lupus erythematosus: Expression patterns of adhesion molecules ICAM-1, VCAM-1 and E-selectin

In our previous study, photoprovocation induced lupus erythematosus (LE) an d polymorphous light eruption-like lesions in photosensitive LE patients, I n this new study we examined the expression of ICAM-1, VCAM-1 and E-selecti n, in early lesions in particular. A total of 32 patients with cutaneous LE , 25 with "classic" discoid LE, and 7 with systemic LE, including 3 patient s with subacute cutaneous LE, were provoked with UVA and UVB on normal appe aring skin. Induced lesions were followed up with serial biopsies. LE-like histopathology was seen within 1 week of provocation in some cases. Adhesio n molecule expression was statistically significantly affected by the facto rs clinical diagnosis and wavelength (UVA or UVB). Strong keratinocyte ICAM -1 expression was found 1 week after provocation in reactions that eventual ly developed into long-standing ones. It is possible that these early chang es reflect an underlying defect in the mechanisms that regulate adhesion mo lecule expression in LE.