Correlations study between cutaneous disease severity and systemic disease severity in SLE (Systematic Lupus Erythematosus) patients

ABSTRACT

Introduction: Skin is the second most commonly affected organ in SLE. Lupus-specific cutaneous LE(CLE) is classified according to Gilliam Classification into acute CLE (ACLE), subacute CLE(SCLE), chronic CLE(CCLE). CLASI (CLE Disease Activity and Severity Index) is an outcome measures to asses cutaneous activity Objectives: To study the correlation between cutaneous disease severity and severity of systemic disease using SLEDAI (SLE Disease Severity Index) and SLICC / ACR (Systemic Lupus International Collaborating Clinics) outcome measures. Methods: Study design: Cross-sectional A total of 71 patients were recruited from Dermatology and Rheumatology Clinic from Kuala Lumpur Hospital, Selayang Hospital and Pusat Perubatan UKM. Study period was from December 2009 to August 2010. Study data were obtained from clinical history, examination, investigations and medical record review. Results: The mean CLASI activity/damage scores in patients with ACLE, SCLE and CCLE were 11.8 / 8.1, 22.6 / 17.2 and 21.1 / 22.1 respectively. The mean SLEDAI/SLICC scores in similar group of patients were 12.3 / 2.1, 6.8 / 1.6, 13.2 / 1.7 respectively. The cutaneous disease activity in patients with SCLE was found to be inversely correlated to systemic disease activity. The cutaneous damage in patients with CCLE was positively correlated with systemic disease damage Conclusions: Patients with SCLE, despite having high cutaneous disease activity, had mild systemic disease. Patients with CCLE whom had high cutaneous damage scores were more likely to have higher systemic damage, hence more thorough investigations to seek other organs damage, should be offered.