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The impact of skin damage due to cutaneous lupus on quality of life
Author(s) -
Verma S.M.,
Okawa J.,
Propert K.J.,
Werth V.P.
Publication year - 2014
Publication title -
british journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.304
H-Index - 179
eISSN - 1365-2133
pISSN - 0007-0963
DOI - 10.1111/bjd.12653
Subject(s) - veterans affairs , medicine , biostatistics , dermatology , family medicine , library science , epidemiology , pathology , computer science
Summary Background Patients with more severe cutaneous lupus erythematosus ( CLE ) have a poorer quality of life ( Q o L ). Racial and ethnic disparities have been reported in disease activity and outcomes in systemic lupus erythematosus, but similar information is not available for CLE . Objectives To evaluate the impact of lupus‐related skin damage on skin‐specific Q o L , and to analyse differences stratified by ethnic background. Methods Data collected included sex, race, diagnosis and C utaneous L upus E rythematosus D isease A rea and S everity I ndex ( CLASI ) and S kindex‐29 scores. These parameters were analysed at the initial and last visits. CLASI damage scores (dyspigmentation and scarring) and activity scores were collected, grouped by ethnicity, and correlated with S kindex‐29. Overall, 223 patients were analysed at baseline, with 141 completing more than one study visit. Results The majority of patients were white (63·7%), followed by A frican A merican (29·1%) and A sian A merican (4·0%). A frican A merican patients accounted for a disproportionate percentage of both localized (50%) and generalized discoid lupus erythematosus ( DLE ) (49%). Median CLASI damage scores differed significantly between the A frican A merican, white and A sian A merican patients, at both the first (8·5, 4·0, 7·0, respectively; P < 0·0001) and last visit (10·0, 6·0, 8·5, respectively; P < 0·01). CLASI damage scores in A frican A mericans correlated with CLASI activity scores ( S pearman r = 0·45, P = 0·0003). Conclusions There was no significant correlation between CLASI damage scores and S kindex domains overall. Individually, dyspigmentation and scarring also did not have a significant effect on Q o L . Ethnic differences in patients with CLE were found: A frican A merican patients exhibited a high rate of DLE and experienced damage early in their disease course, frequently in conjunction with disease activity.