Skiljevic, D. (23487265400)D. (23487265400)SkiljevicBonaci-Nikolic, B. (10839652200)B. (10839652200)Bonaci-NikolicBrasanac, D. (6603393153)D. (6603393153)BrasanacNikolic, M. (56910382000)M. (56910382000)Nikolic2025-06-122025-06-122017https://doi.org/10.1111/jdv.13943https://www.scopus.com/inward/record.uri?eid=2-s2.0-84990199995&doi=10.1111%2fjdv.13943&partnerID=40&md5=4f1f732b200fdd965c8409aa2fec4edbhttps://remedy.med.bg.ac.rs/handle/123456789/7072Background: Dysregulation of apoptosis has an important role in the induction of autoimmunity. Objective: To evaluate the influence of keratinocyte apoptosis and deoxyribonuclease I (DNase I) activity on the clinical and immunoserological parameters of cutaneous lupus erythematosus (CLE). Methods: We studied 69 CLE patients (39 with discoid LE (DLE), 12 with subacute CLE (SCLE), 12 with acute and 6 with intermittent CLE). Thirty of sixty-nine patients fulfilled criteria for systemic LE (SLE). Apoptotic index (AI) was evaluated immunohistochemically in lesional and non-lesional, photoprotected skin. Serum DNase I activity, antichromatin and anti-ENA antibodies were measured by ELISA. Disease activity was determined by SLEDAI-2K, SLICC/ACR, CLASI and RCLASI. Results: AI in lesions was higher than in non-lesional skin (P < 0.001). There was no difference in AI between CLE and SLE patients. Patients with SCLE had higher lesional AI than patients with DLE (P < 0.05). We found a positive correlation between the lesional AI with CLASI A (P < 0.05) and RCLASI D (P < 0.05). CLE and SLE patients had significantly lower DNase I activity than healthy controls (P < 0.001). Patients with normal DNase I activity and low AI had significantly lower CLASI A than patients with decreased DNase I activity and/or elevated AI (P < 0.05). Conclusions: Increased keratinocyte apoptosis characterizes lesions of all CLE forms, especially of SCLE. AI correlates with CLE markers of acute and chronic inflammation. Normal level of apoptosis and DNase I activity simultaneously reduce the level of acute inflammation in CLE. Serum DNase I activity and AI might be important biomarkers in the evaluation of CLE patients. © 2016 European Academy of Dermatology and Venereology