Healio
Healio
October 28, 2015
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Patient-reported cutaneous lupus erythematosus screening tool may be effective

A self-administered, 15-question screening tool may be effective at identifying patients with cutaneous lupus erythematosus, according to research published in JAMA Dermatology.

Researchers developed a questionnaire with 15 yes-or-no questions based on the opinion of experienced researchers and the Delphi method, the Cutaneous Lupus Screening (CLUSE) tool. The questionnaire included three questions about the patient’s health care practitioner, photosensitivity and images of skin conditions that may mimic cutaneous lupus erythematosus (CLE), such as psoriasis, eczema, urticaria and rosacea.

Nine algorithms were developed to identify CLE and its subtypes based on a priori hypotheses ascertained through the Delphi method. Certain combinations of affirmative responses were identified to distinguish CLE subtypes, such as discoid CLE.

Responses from 117 participants, including 24 patients with cutaneous lupus erythematosus (CLE) were evaluated. Affirmative responses to questions on the CLUSE tool were assigned a value of 1 while negative responses were assigned a value of 0 and algorithms were applied. No patients with acute CLE participated, which precluded the evaluation of algorithms 5 and 6.

The highest sensitivity (87.5%) was demonstrated with algorithm 9 which was designed to identify CLE regardless of subtype and showed a specificity of 96.8%. Algorithm 7 used to diagnose CLE was 70.8% sensitive and 97.8% specific. Algorithm 3 was designed to identify systemic CLE and had a sensitivity of 76.9% and specificity or 97.1%. Algorithm 2, designed to identify discoid CLE, had the lowest sensitivity of 33.3% and specificity of 97.1%.

The individual question with the highest sensitivity (91.7%) was related to the presence of a diagnosis by a dermatologist and was 93.5% specific. Participants who had non-CLE dermatoses who responded affirmatively to questions about prior diagnoses with other skin disorders that can mimic CLE were unlikely to respond affirmatively to an image of a CLE-related rash included in a CLE algorithm. – by Shirley Pulawski

Disclosure: Lam reports the receipt of grant support from Biogen Idec. Please see the full study for a list of all other authors’ relevant financial disclosures.

Sources/Disclosures

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Source:

Lam C, et al. JAMA Dermatol. 2015;doi:10.1001/jamadermatol.2015.3088.