2010 Volume 120 Issue 6 Pages 1209-1216
The collagen fiber attack reaction is a type of tissue reaction proposed by Arai in 2005. It exhibits a vessel-independent pattern of infiltration by histiocytes. Collagen fibers at the site are eosinophilic and swollen. Degenerated collagen fibers are surrounded by migrating histiocytes, which are attacking these fibers. We have observed this type of tissue reaction in eruptions associated with systemic lupus erythematosus (SLE), Sjogrenʼs syndrome, mixed connective-tissue disease (MCTD), dermatomyositis, and rheumatoid arthritis. This report describes the clinical characteristics of 8 cases of SLE with evidence of collagen fiber attack reaction. Highly infiltrative regions of eruption with unclear margins appeared with fever and resolved in about two weeks. Nonspecific reactions observed include increases in white blood cell count, CRP, and LDH, with only minimal changes in SLE-specific serological markers. The clinical courses of affected patients were similar to those in cases of exudative erythema or neutrophilic erythema. The collagen fiber attack reaction resolves within a short period of timeʼ therefore, it is probably not autoimmune-mediated.