Skin is one of the main target organs in lupus erythematosus and in some circumstances, skin lesions precede systemic manifestations. Previous studies have demonstrated that Ro/SSA antigen antibody might be involved in the pathogenesis of lupus erythematosus. The present study was performed to investigate the factors regulating expression of Ro/SSA antigens on the cell surface of keratinocytes. Cultured normal human keratinocytes were treated with 50-200 mJ/cm(2) of ultraviolet B (UVB) irradiation, 10(-9) to 10(-5) mol/l of 17beta-estradiol, 5-10 microg/l of phorbol 12-myristate 13-acetate (PMA), and 42 and 45 degrees C heat shock, respectively. The Ro/SSA antigen expressions were determined by indirect immunofluorescence. The results showed that keratinocytes receiving UVB irradiation expressed Ro/SSA antigen on cell membranes in a dose-dependent fashion. 17beta-estradiol treatment also induced Ro/SSA antigen expression dose-dependently. Keratinocyte expression of Ro/SSA antigens was also induced by heat shock stimulation. The 45 degrees C heat shock showed a stronger effect than 42 degrees C heat shock. Keratinocytes incubated for 24 h after heat shock had more antigen-expressing cells than those incubated for 6 h after heat shock. PMA at 5 and 10 microg/l also strongly induced Ro/SSA antigen expression. These results suggest that Ro/SSA antigen expression can be regulated by many factors and that protein kinase C signal transduction pathway might be involved in this process.