Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Feb;170(2):315-21.
doi: 10.1111/bjd.12653.

The impact of skin damage due to cutaneous lupus on quality of life

S M Verma  1 , J Okawa, K J Propert, V P Werth
Affiliations

The impact of skin damage due to cutaneous lupus on quality of life

S M Verma et al. Br J Dermatol. 2014 Feb.

Abstract

Background: Patients with more severe cutaneous lupus erythematosus (CLE) have a poorer quality of life (QoL). Racial and ethnic disparities have been reported in disease activity and outcomes in systemic lupus erythematosus, but similar information is not available for CLE.

Objectives: To evaluate the impact of lupus-related skin damage on skin-specific QoL, and to analyse differences stratified by ethnic background.

Methods: Data collected included sex, race, diagnosis and Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI) and Skindex-29 scores. These parameters were analysed at the initial and last visits. CLASI damage scores (dyspigmentation and scarring) and activity scores were collected, grouped by ethnicity, and correlated with Skindex-29. Overall, 223 patients were analysed at baseline, with 141 completing more than one study visit.

Results: The majority of patients were white (63·7%), followed by African American (29·1%) and Asian American (4·0%). African American patients accounted for a disproportionate percentage of both localized (50%) and generalized discoid lupus erythematosus (DLE) (49%). Median CLASI damage scores differed significantly between the African American, white and Asian American patients, at both the first (8·5, 4·0, 7·0, respectively; P < 0·0001) and last visit (10·0, 6·0, 8·5, respectively; P < 0·01). CLASI damage scores in African Americans correlated with CLASI activity scores (Spearman r = 0·45, P = 0·0003).

Conclusions: There was no significant correlation between CLASI damage scores and Skindex domains overall. Individually, dyspigmentation and scarring also did not have a significant effect on QoL. Ethnic differences in patients with CLE were found: African American patients exhibited a high rate of DLE and experienced damage early in their disease course, frequently in conjunction with disease activity.

PubMed Disclaimer

Figures

Figure 1
Figure 1. The Distribution of the Median CLASI Damage Scores at First and Last Visits in Different Ethnicities
African Americans had higher damage scores at visit 1 and did not change much over time, in contrast to Caucasians, who had low damage scores at visit 1 and increased at the last visit. There was a significant difference in median CLASI damage scores between each population of different racial backgrounds at first and last visit (p<0.0001, p=0.0036) and specifically between African Americans and Caucasians at first and last visits (p<0.0001, p<0.001).
Figure 2
Figure 2. Correlations of CLASI Damage Scores and Skindex-29 Domains in Different Ethnicities
CLASI Damage scores did not correlate with the Skindex emotion or function domains. There was a correlation between CLASI Damage scores and Skindex-29 Symptoms scores, in African Americans but not in Caucasians.
Figure 2
Figure 2. Correlations of CLASI Damage Scores and Skindex-29 Domains in Different Ethnicities
CLASI Damage scores did not correlate with the Skindex emotion or function domains. There was a correlation between CLASI Damage scores and Skindex-29 Symptoms scores, in African Americans but not in Caucasians.
Figure 3
Figure 3. The Effect of Distribution of Dyspigmentation and Scarring on Skindex-29 Emotion Scores
There was no significant difference seen in the Skindex-29 emotion scores based on the distribution of dyspigmentation and scarring.
Figure 3
Figure 3. The Effect of Distribution of Dyspigmentation and Scarring on Skindex-29 Emotion Scores
There was no significant difference seen in the Skindex-29 emotion scores based on the distribution of dyspigmentation and scarring.
Figure 4
Figure 4. The Correlation between CLASI Damage and Activity Scores in African Americans and Caucasians
There was a strong correlation between disease activity and damage in African Americans, but this was not true in Caucasians.
See this image and copyright information in PMC

References

    1. Durosaro O, Davis MD, Reed KB, Rohlinger AL. Incidence of cutaneous lupus erythematosus, 1965-2005: a population-based study. Arch Dermatol. 2009;145(3):249–53. - PMC - PubMed
    1. Tebbe B, Orfanos CE. Epidemiology and socioeconomic impact of skin disease in lupus erythematosus. Lupus. 1997;6(2):96–104. - PubMed
    1. Tan EM, Cohen AS, Fries JF, et al. The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum. 1982;25:1271–7. - PubMed
    1. Hochberg MC. Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum. 1997;40:1725. - PubMed
    1. Fernández M, Alarcón GS, Calvo-Alén J, et al. LUMINA Study Group A multiethnic, multicenter cohort of patients with systemic lupus erythematosus (SLE) as a model for the study of ethnic disparities in SLE. Arthritis Rheum. 2007 May 15;57(4):576–84. - PubMed

Publication types

MeSH terms