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Few cutaneous lupus erythematosus patients developed SLE
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Less than 20% of patients with cutaneous lupus erythematosus later developed systemic lupus erythematosus, and most of the cases were mild, according to recent study reports.
Researchers in Philadelphia conducted a prospective, longitudinal study of 77 patients with cutaneous lupus erythematosus (CLE) who enrolled between January 2007 and April 2011 in a University of Pennsylvania autoimmune skin disease clinic. Data recorded from study visits and medical records determined systemic symptoms and severity.
During the study period, 13 CLE patients (17%) met criteria for systemic lupus erythematosus (SLE; mean age, 50.35 years; 92% women) with a mean follow-up of 2.81 years. All patients developed SLE more than 6 months after being diagnosed with CLE, with the mean time to diagnoses of 8.03 years.
SLE criteria developed by patients included hematologic involvement (n=4), arthritis (n=3), malar rash (n=3), renal involvement (n=2), photosensitivity (n-2), oral ulcers (n=2) and discoid rash (n=2). Mucocutaneous American College of Rheumatology (ACR) criteria of malar rash, discoid rash, photosensitivity and oral ulcers was met by one patient, while three patients met mucocutaneous ACR criteria plus positive antinuclear and other antibody titers. Moderate to severe additional systemic disease was developed by five of the SLE patients (38%), including three with musculoskeletal involvement and two with new renal disease.
“Patients with CLE who developed SLE during our study did so mostly by meeting the mucocutaneous ACR criteria, and the majority developed none to mild additional systemic disease during the study period,” the researchers concluded. “Clinicians can use these data to counsel patients with newly diagnosed CLE that few will go on to develop SLE, and that even if they do, they are likely to have mild systemic symptoms.”
Disclosure: The researchers report no relevant financial disclosures.
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