Epidemiology of Systemic Lupus Erythematosus and Cutaneous Lupus Erythematosus in a Predominantly White Population in the United States

Abstract

Objective Epidemiologic studies comparing the incidence and prevalence of systemic lupus erythematosus (SLE) and isolated cutaneous lupus erythematosus (CLE) are few. Olmsted County, Minnesota provides a unique setting for such a study owing to resources of the Rochester Epidemiology Project. We sought to describe and compare the incidence and prevalence of SLE and CLE from 1993 to 2005. Methods SLE cases were identified from review of medical records and fulfilled the 1982 ACR classification criteria. CLE cases included patients with classic discoid LE (CDLE), subacute cutaneous LE (SCLE), lupus panniculitis and bullous LE. Age-and sex-adjusted incidence and prevalence were standardized to 2000 US white population. Results The age- and sex-adjusted incidence of SLE (2.9 per 100,000; 95% CI 2.0, 3.7) was similar to that of CLE (4.2 per 100,000; 95% CI 3.1, 5.2, p= 0.10). However, incidence of CLE was three times higher than SLE in males (2.4 versus 0.8 per 100,000, p=0.009). The age- and sex-adjusted prevalence of CLE on January 1, 2006 was higher than that of SLE (70.4 versus 30.5 per 100,000; p<0.001). The prevalence of CLE and SLE in women were similar but the CLE prevalence was higher in men than in women (56.9 versus 1.6 per 100,000, p<0.001). The incidence of CLE rose steadily with age and peaked at 60-69 years. Conclusion The incidences of CLE and SLE are similar but CLE is more common than SLE in males and in older adults. These findings may reflect differences in genetic or environmental etiology of CLE.

Prevalence of Skin and Skin-Related Diseases in the Rochester Epidemiology Project and a Comparison with Other Published Prevalence Studies

“…The prevalences of scleroderma in Detroit, Mich., USA [36], areas of Canada [37, 38], and South Australia [39] were higher than the prevalence reported in Olmsted County [10]. The prevalence of SLE varied considerably over the years in Olmsted County, but was similar to other white populations in Europe and the USA [10–13, 40–42]. …”

“…In Nobrega et al [14], combined SLE is defined as classic SLE (positive LE cell test and ≥3 major systemic manifestations of LE) plus rheumatoid arthritis with LE (previous rheumatoid arthritis with positive LE cell test and ≥3 major systemic manifestations of LE). As for Durosaro et al [15] and Jarukitsopa et al [13], both studies reported the point prevalence of cutaneous lupus erythematosus for the Olmsted County population in January 2006. Differences in these prevalences are due to differences in the methodology used in defining the denominator and in adjusting the population.…”

Cancer risk in cutaneous lupus erythematosus: a population-based cohort study

“…Cutaneous lupus erythematosus (CLE), defined as isolated cutaneous lupus lesions occurring in the absence of significant evidence of SLE, has a 2-to 3-fold higher prevalence than SLE, with a peak incidence in the seventh decade of life [7]. There are limited data on whether CLE affects cancer risk.…”

Introduction and Physiology of Lupus

“…It was also seen that the incidence in women was much more (almost nine times more in women than in men) than that in men [71].…”