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Cutaneous lupus erythematosus patients reported photosensitivity levels based on disease activity
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Patients with cutaneous lupus erythematosus reported photosensitivity symptoms based on disease activity levels, according to study results.
Researchers interviewed 91 patients with cutaneous lupus erythematosus (CLE) or CLE and systemic lupus erythematosus (SLE; mean age, 46 years; 73 women) at an autoimmune skin disease clinic at the University of Pennsylvania. The patients participated in a photosensitivity (PS) survey that classified responses into five phenotypes: direct sun-induced CLE flare (directCLE), general exacerbation of CLE (genCLE), polymorphic light eruption-like reactions (genSkin), general pruritis/paresthesias (genRxn) and sun-induced systemic symptoms (genSys).
Eighty-one percent of patients reported one or more of the phenotypes; of them, 86% cited CLE-specific reactions, including directCLE or genCLE.
In multivariable regression analyses, elevated CLE disease activity (measured by CLE Disease Area and Severity Index scores) was statistically suggestive of an association with directCLE reactions (P=.093).
GenSkin and genRxN were described by 60% of photosensitive patients.
“These phenotypes often co-occurred with CLE-specific reactions and were predicted by more systemic disease activity as measured by Physicians Global Assessment [PGA] scores in regression analyses [genSkin, P=.017] and [genRxn, P=.051],” the researchers reported.
Systemic reactions were reported by 36% of patients, with the sun-induced systemic symptoms phenotype predicted by higher PGA scores (P=.02) but not by SLE diagnosis (P=.14).
Researchers said the study was limited because PS was inferred from patient surveys and not directly observed.
“Characterization of self-reported PS in LE reveals that patients experience combinations of CLE-specific, CLE-nonspecific, and systemic reactions to sunlight,” the researchers concluded. “Sun-induced CLE flares are associated with more active CLE disease. [GenSkin, genRxn] and systemic reactions are associated with more active systemic disease.
“Recognition of PS phenotypes will permit improved definitions of clinical PS and allow for more precise investigation into its pathophysiology.”
Disclosure: The researchers report no relevant financial disclosures.
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