Oral Ulcers in Systemic Lupus Erythematosus – Relationship With Disease Duration and Severity

Abstract

Objective: This study was conducted to assess the prevalence of oral ulceration among systemic lupus erythematosus patients in Pakistan and their relationship with disease duration and severity. Materials & Methods: This cross-sectional study was conducted at Clinic for Arthritis and Rheumatic Diseases, DHQ Hospital, Rawalpindi Medical University, Pakistan. 75 adult patients, fulfilling the 1997 American College of Rheumatology diagnostic criteria for SLE, between January and December 2018 were included in the study. Clinical signs comprising of oral cavity were documented and their relationship to disease duration in years and organ damage using SLICC/ACR-DI score was studied. Descriptive statistics and logistic regression analysis were performed for statistical assessment. Results: 75 patients with SLE were included in the study. Female to male ratio was 9.5:1 (94.7% females and 5.3% males) and mean age of patients was 30.65 ± 10.71 years. 34 patients (45.3%) had oral ulcers. No significant association was observed between presence of oral ulcers with age (p-value= 0.43), with gender (p-value= 0.618) and disease duration (p-value=0.10). However, mean SLICC/ACR-DI score for SLE patients with oral ulcers was 2.0 as compared to 0.8 for the patients without oral ulcers (p-value=0.001). Conclusion: This study found that Pakistani patients with SLE have high prevalence (45.3%) of oral ulceration, especially in patients with poorly controlled disease and more evidence of organ damage. This warrants the need to create awareness about disease among healthcare workers and patients.