Systemic correlates of cutaneous manifestations of lupus erythematosus

Peter M Heil; Mark R Pittelkow; Amy L Weaver; Jill M Killian; Olayemi Sokumbi; David A Wetter

doi:10.1111/ijd.17178

Systemic correlates of cutaneous manifestations of lupus erythematosus

Int J Dermatol. 2024 May 10. doi: 10.1111/ijd.17178. Online ahead of print.

Authors

Peter M Heil^{1

2}, Mark R Pittelkow³, Amy L Weaver⁴, Jill M Killian⁴, Olayemi Sokumbi⁵, David A Wetter⁶

Affiliations

¹ Department of Dermatology, Medical University of Vienna, Vienna, Austria.
² Visiting Research Fellow, Mayo Clinic, Rochester, MN, USA.
³ Department of Dermatology, Mayo Clinic, Scottsdale, AZ, USA.
⁴ Division of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, MN, USA.
⁵ Department of Dermatology, Mayo Clinic, Jacksonville, FL, USA.
⁶ Department of Dermatology, Mayo Clinic, Rochester, MN, USA.

PMID: 38727096
DOI: 10.1111/ijd.17178

Abstract

Background: We aimed to investigate the prevalence of skin disease among patients with systemic lupus erythematosus (SLE) and determine whether LE skin disease had clinical or serologic correlates with SLE.

Methods: We reviewed records of 335 patients with SLE (seen at Mayo Clinic, Rochester, Minnesota, USA) and abstracted skin manifestations, fulfilled mucocutaneous SLE criteria, and clinical and serologic parameters.

Results: Of the 231 patients with skin manifestations, 57 (24.7%) had LE-specific conditions, 102 (44.2%) had LE-nonspecific conditions, and 72 (31.2%) had both. LE skin disease was associated with photosensitivity, anti-Smith antibodies, and anti-U1RNP antibodies (all P < 0.001). Patients without LE skin disease more commonly had elevated C-reactive protein levels (P = 0.01). Patients meeting 2-4 mucocutaneous American College of Rheumatology criteria less commonly had cytopenia (P = 0.004) or anti-double-stranded DNA antibodies (P = 0.004). No significant associations were observed for systemic involvement (renal, hematologic, neurologic, and arthritis) when comparing patients with or without LE skin involvement. LE skin involvement was not significantly associated with internal SLE disease flare, number of medications, or overall survival.

Conclusions: LE skin disease commonly occurs in patients with SLE. The presence of LE skin disease had no mitigating impact on the severity of SLE sequelae, disease flares, number of medications, or overall survival.

Keywords: antinuclear antibody; autoimmune diseases; collagen vascular diseases; cutaneous lupus erythematosus; discoid lupus erythematosus; lupus; survival rates; systemic lupus erythematosus.