Lupus erythematosus skin disease does not impact severity of systemic lupus

Key takeaways:

• Patients with lupus skin disease had similar survival rates and flares as those without skin manifestations.
• Due to the impact on quality of life, dermatologists must be involved in caring for lupus patients.

Skin disease manifestations in systemic lupus erythematosus do not have an impact on disease severity, according to a study.

“Skin manifestations of systemic lupus erythematosus are myriad and can have a dramatic impact on patients’ lives,” Peter M. Heil, MD, senior physician in the department of dermatology at the Medical University of Vienna, and colleagues wrote. “Our study ... investigated the range of skin disease that occurs in patients with [systemic lupus] and showed that these skin manifestations require as much systemic treatment comparable to those used for other organs affected by [systemic lupus] in patients without skin findings.”

The study included 231 patients with skin manifestations who had lupus-specific conditions (n = 57; 24.7%), lupus-nonspecific conditions (n = 102; 44.2%) or both (n = 72; 31.2%).

Among those with both lupus-specific or lupus-nonspecific disease, photosensitivity was significantly more common among patients who had any skin involvement vs. those with no skin lesions (40.3% vs. 20.2%; P < .001). Similarly, those with skin involvement more commonly had anti-Smith antibodies (33.3% vs. 10.6%; P < .001) and anti-U1RNP antibodies (50.5% vs. 22.8%; P < .001) compared with patients without skin manifestations.

Patients with lupus skin disease did not receive more systemic treatments vs. those without skin disease (3.7 vs. 3.4). There was also no difference in survival rates or systemic lupus flares between those with vs. without lupus skin disease.

While the presence of lupus skin disease had no mitigating impact on the severity of systemic lupus, the authors did find that these skin manifestations can become a quality of life burden.

Acute cutaneous lupus, which refers to a group of inflammatory skin conditions that affect patients with lupus, including the butterfly rash, affected 27.8% of those with systemic lupus, making it the most common skin manifestation. Other skin manifestations, such as erosive and ulcerating oronasal mucous membrane lesions, which can be quite painful and burdensome to patients, affected 26.3% of the cohort.

According to the authors, these findings emphasize the value of clinical awareness among dermatologists about developing skin manifestations.

“Dermatologists should be involved in the routine and scientific care of all patients with [systemic lupus],” they concluded.