Classification of disease damage and activity in cutaneous lupus erythematosus: A cross-sectional analysis

Abbas, L.; Nandy, Karabi; Chong, Benjamin F.

doi:10.1016/j.jaad.2022.04.045

Cited by 3 publications

(5 citation statements)

References 4 publications

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“…A total of 154 adult patients with DLE (128 women [83%] and 26 men [17%]; mean [SD] age, 43 [13] years) were included in the analysis (Table 1). Race and ethnicity were classified by selfreporting.…”

Section: Resultsmentioning

confidence: 99%

“…12 Damage severity was classified as mild (<6) or moderate to severe (≥6) using the CLASI damage score (CLASI-D). 13 Activity severity was classified as mild (<10) or moderate to severe (≥10) using the CLASI activity score (CLASI-A). 11 We examined the association of various demographic and socioeconomic indicators, including race, sex, presence of SLE, smoking status, and age at diagnosis.…”

Section: Methodsmentioning

confidence: 99%

“…Damage severity was classified as mild (<6) or moderate to severe (≥6) using the CLASI damage score (CLASI-D) . Activity severity was classified as mild (<10) or moderate to severe (≥10) using the CLASI activity score (CLASI-A) .…”

Section: Methodsmentioning

confidence: 99%

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Area Deprivation and Disease Severity in Adult Patients With Discoid Lupus Erythematosus

Faden,

Xie,

Stone

et al. 2024

JAMA Dermatol

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ImportanceThe association of area deprivation with outcomes in discoid lupus erythematosus (DLE) remains poorly understood.ObjectiveTo determine the association between US Census block measures of deprivation and disease severity in adult patients with DLE.Design, Setting, and ParticipantsThis cross-sectional study included 154 patients with DLE seen between January 1, 2007, and January 1, 2024, at a single-center referral-based specialty rheumatologic-dermatology clinic in Philadelphia, Pennsylvania. Patients were aged 18 to 73 years and were enrolled in the University of Pennsylvania’s Cutaneous Lupus Erythematosus Database study. Data were analyzed between January 1, 2024, and May 8, 2024.ExposuresResidence in a highly disadvantaged area as geocoded by a state area deprivation index (ADI).Main Outcomes and MeasuresThe main outcome was DLE disease severity as codified by the validated Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI) damage and activity scores.ResultsA total of 154 adult patients with DLE (128 women [83%] and 26 men [17%]; mean [SD] age, 43 [13] years; 6 [4%] Asian individuals, 98 [64%] Black individuals, 2 [1%] Hispanic individuals, 46 [30%] White individuals, and 2 individuals [1%] with other race or ethnicity; 78 [51%] with an ADI &gt;5; 43 who currently smoked [28%];and 56 [36%] with concurrent systemic lupus erythematosus) were included in the analysis. By multivariable logistic regression, residence within communities with an ADI greater than 5 was associated with nearly 4-fold greater odds of moderate to severe damage (odds ratio [OR], 3.90; 95% CI, 1.27-12.69] and activity (OR, 3.31; 95% CI, 1.27-9.44). Concurrent cigarette smoking was similarly associated with greater odds of moderate to severe damage (OR, 3.15; 95% CI, 1.09-10.29). After controlling for ADI and other confounders, race was not significantly associated with DLE disease severity.Conclusions and RelevanceThe results of this cross-sectional study suggest that geospatial disadvantage is associated with DLE disease severity independent of race. This invites a paradigm shift that considers the social context within which racial disparities are observed, highlighting the potential for geographically targeted interventions and policy changes to improve patient outcomes in DLE.

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Area Deprivation and Disease Severity in Adult Patients With Discoid Lupus Erythematosus

Faden,

Xie,

Stone

et al. 2024

JAMA Dermatol

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“…Clinical and dermoscopic lesion locations were determined according to the CLASI classification [15]. CLASI-A scores were grouped into disease activity levels of mild (0-9), moderate (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20), and severe (21-70) as recommended by Klein et al [16]. CLASI-D scores were grouped into disease severity levels of mild (0-5), moderate (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16), and severe (≥17) [17].…”

Section: Methodsmentioning

confidence: 99%

“…CLASI-A scores were grouped into disease activity levels of mild (0-9), moderate (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20), and severe (21-70) as recommended by Klein et al [16]. CLASI-D scores were grouped into disease severity levels of mild (0-5), moderate (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16), and severe (≥17) [17].…”

Section: Methodsmentioning

confidence: 99%

Dermoscopic Characteristics of Cutaneous Lupus Erythematosus According to Subtype, Lesion Location, Lesion Duration, and CLASI Score

Gürsel Ürün,

Ürün,

Danışman

2024

Dermatol Pract Concept

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Introduction: Dermoscopic findings are used to diagnose and evaluate disease activity in patients with cutaneous lupus erythematosus (CLE). Objectives: This study aimed to characterize the dermoscopic features of discoid LE (DLE) and LE tumidus (LET) by lesion duration and CLE Disease Area and Severity Index (CLASI) scores and to examine the dermoscopic findings of lesions in different locations in DLE patients. Methods: Dermoscopic findings (follicular features, perifollicular surface, interfollicular features, and vessel pattern) were assessed and lesion duration (≤12 and >12 months) and CLASI scores (grouped as mild or moderate) were calculated. DLE lesion locations were categorized as, non-scalp, scalp and lip. Results: Forty-eight dermoscopic images from 35 DLE and 4 LET patients were analyzed. The most common dermoscopic findings in non-scalp DLE were follicular keratotic plugs (82.8%) and white scales (69%). In scalp DLE (n=9), the most common findings were absent follicular openings (77.8%), white structureless areas (77.8%), and perifollicular scaling (66.7%). All LET patients had pink-white background and linear vessels. Follicular plugs, peripheral pigmentation, and polymorphous vessels were lower in patients with mild CLASI activity than moderate activity (P = 0.036, 0.039, and 0.019, respectively). Fibrotic white dots, honeycomb pigment pattern, and blue-gray dots/globules were lower in those with mild CLASI damage scores than moderate damage (P = 0.010, 0.010, and 0.020, respectively). Peripheral pigmentation was more common in patients with lesion duration ≤12 months, while blue-gray dots/globules were more common with lesion durations >12 months. Conclusions: Certain dermoscopic features may facilitate the differential diagnosis of DLE and LET.

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Severity Scores for Cutaneous Lupus Erythematosus

Cepica,

Gupta,

Werth

et al. 2024

Journal of Investigative Dermatology

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Classification of disease damage and activity in cutaneous lupus erythematosus: A cross-sectional analysis

Cited by 3 publications

References 4 publications

Area Deprivation and Disease Severity in Adult Patients With Discoid Lupus Erythematosus

Area Deprivation and Disease Severity in Adult Patients With Discoid Lupus Erythematosus

Dermoscopic Characteristics of Cutaneous Lupus Erythematosus According to Subtype, Lesion Location, Lesion Duration, and CLASI Score

Severity Scores for Cutaneous Lupus Erythematosus

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