From the Guidelines
Rash is not a characteristic feature of anti-synthetase (PL-7) antibody syndrome, as the syndrome is primarily associated with mechanic’s hands, arthritis, Raynaud phenomenon, interstitial lung disease, myositis, and fever, but not specifically with a rash 1. The anti-synthetase syndrome, which includes anti-PL-7, is characterized by a set of clinical features that do not typically include a rash as a primary symptom.
- The syndrome is more commonly associated with:
- Mechanic’s hands
- Arthritis
- Raynaud phenomenon
- Interstitial lung disease
- Myositis
- Fever According to the study published in the Mayo Clinic Proceedings 1, the anti-Mi2 antibody is the one that acts against a nuclear helicase involved in transcriptional activation, and patients with this antibody have classic cutaneous features, including Gottron papules, shawl sign, cuticle overgrowth, V-sign, and a heliotrope rash. However, the anti-PL-7 antibody is directed against threonyl-tRNA synthetase, and its clinical features do not typically include a rash 1. Treatment for anti-synthetase syndrome usually involves immunosuppressive medications, such as high-dose corticosteroids, and may include additional treatments like methotrexate or mycophenolate mofetil in severe or refractory cases 1. Regular monitoring of lung function and muscle strength is essential during treatment, but this is not directly related to the management of a rash, as a rash is not a primary symptom of the syndrome.
From the Research
Association between Rash and Anti-Synthetase (PL-7) Antibody Syndrome
- Rash is a common manifestation of anti-synthetase syndrome, as reported in several studies 2, 3, 4.
- A study published in 2022 described a case of a 47-year-old male patient who presented with a skin rash, muscle weakness, and interstitial lung disease, and was subsequently diagnosed with dermatomyositis and anti-synthetase antibody syndrome, including anti-PL-7 antibodies 5.
- Another study published in 2018 reported a case of a 68-year-old woman with anti-PL-7 antisynthetase syndrome who presented with characteristic skin manifestations, including Gottron's sign, interstitial lung disease, and pericardial effusion 3.
- A case report published in 2010 described a 52-year-old man with antisynthetase (anti PL-7 antibody) syndrome who presented with a skin rash and exacerbation of interstitial pneumonia during treatment for rheumatoid arthritis 4.
- These studies suggest that rash is a significant clinical feature of anti-synthetase (PL-7) antibody syndrome, and its presence should prompt further investigation for this condition 5, 2, 3, 4.
Clinical Features of Anti-Synthetase (PL-7) Antibody Syndrome
- Anti-synthetase syndrome is characterized by a range of clinical features, including interstitial lung disease, myositis, arthritis, Raynaud's syndrome, fever, and rashes 2.
- The presence of anti-PL-7 antibodies is a specific marker for this syndrome, and its detection is essential for diagnosis 5, 3, 4.
- The clinical manifestations of anti-synthetase syndrome can vary depending on the specific antisynthetase antibodies present, and the diagnosis should be considered in patients with unexplained inflammatory myopathy, interstitial lung disease, or other characteristic features 2.
Diagnosis and Treatment of Anti-Synthetase (PL-7) Antibody Syndrome
- The diagnosis of anti-synthetase syndrome is based on the presence of anti-aminoacyl tRNA synthetase antibodies, including anti-PL-7 antibodies, and characteristic clinical features 5, 2, 3, 4.
- Treatment of anti-synthetase syndrome typically involves immunosuppressive therapy, such as prednisolone and other agents, to control the inflammatory response and prevent organ damage 5, 3, 4.