Revised Cutaneous Lupus Erythematosus Disease Area and Severity Index (RCLASI): a modified outcome instrument for cutaneous lupus erythematosus

Kuhn, Annegret; Amler, Susanne; Beissert, Stefan; Böhm, Markus; Brehler, Randolf; Ehrchen, Jan; Grundmann, Sonja; Haust, Merle; Ruland, Vincent; Schiller, Meinhard; Schulz, Peter J.; Ständer, Sonja; Sauerland, Cristina; Luger, Thomas A.; Bonsmann, Gisela

doi:10.1111/j.1365-2133.2010.09799.x

Cited by 107 publications

(86 citation statements)

References 15 publications

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“…Furthermore, it is still unknown if it is feasible for rare variants of CLE, like LE panniculitis or chilblain LE. Some modifications of CLASI have been proposed, but to date no instrument assessing CLE severity really overcame previous shortcomings [20,21]. Furthermore, to the best of our knowledge, no currently available CLE severity scoring system takes into consideration subjective symptoms and patient's perspective of having skin lesions in LE.…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics of cutaneous lupus erythematosus

Szczęch

Rutka

Samotij

et al. 2016

pdia

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13 IntroductionLupus erythematosus (LE) is a chronic autoimmune disease with a wide spectrum of presenting symptoms ranging from mild cutaneous manifestations in localized cutaneous LE (CLE) to severe, life-threatening internal organ damage in systemic LE (SLE). The etiology of LE remains unknown, although the environmental, genetic, viral and hormonal factors are taken into consideration as probable causes or precipitating factors of this disease [1,2].Skin involvement is seen in about 70-85% of all LE patients [3]. Sometimes skin involvement is the only manifestation of LE, while in other cases it could rather be a mild bystander of severe internal involvement. Isolated CLE is a rare disease, albeit it is still about 2 to 3 times more frequent than SLE [4]. Cutaneous features of LE can be classified into LE-specific and LE-nonspecific ones. LEspecific skin lesions usually appear only in patients with LE and thus can be handled as diagnostic ones (e.g. "ma- Aim: To analyze the clinical presentation of cutaneous variants of lupus erythematosus in terms of skin lesion spectrum and extracutaneous involvement. Material and methods: A total of 64 patients with cutaneous LE (CLE) were included. The study was based on the "Core Set Questionnaire" developed by the European Society of Cutaneous Lupus Erythematosus (EUSCLE). Clinical severity of skin lesions was evaluated with the Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI). All results were subjected to statistical analysis. Results: Fifteen (23.4%) patients had an acute CLE (ACLE), 26 (40.6%) subacute CLE (SCLE) and 21 (32.8%) chronic CLE (CCLE). Two (3.2%) individuals only demonstrated urticarial vasculitis as a cutaneous manifestation of LE and these patients were excluded. Patients with ACLE were characterized by the earliest onset of the disease (mean age of 31.9 ±15.0 years; p < 0.001). On average, 4.8 ±1.8 criteria of systemic LE were found in the ACLE group compared to 2.7 ±1.3 criteria in SCLE and 2.5 ±1.5 criteria in CCLE (p < 0.001). The highest activity of skin lesions according to CLASI was found in the SCLE group (p = 0.002). On the other hand, the most severe skin damage was observed in CCLE (p < 0.01). Conclusions: Each variant of CLE differs significantly from the others in respect of various aspects of clinical manifestations. Due to a number of different variants of LE skin lesions, a unified classification of CLE still remains a challenge.

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Section: Discussionmentioning

confidence: 99%

Clinical characteristics of cutaneous lupus erythematosus

Szczęch

Rutka

Samotij

et al. 2016

pdia

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“…Ancak çoğu hasta, saç kaybının süresinin farkında olmamakta ve bu durum objektif bir skorlamadan bizi uzaklaştırmaktadır. Bu nedenlerden dolayı KLASİ çeşitli noktalarda yeniden gözden geçirilmiştir 1 . RKLASİ'de, aktivite skoruna ödem/infiltasyon, subkutan nodül-plak olmak üzere iki ayrı madde ilave edilmiştir.…”

Section: Discussionunclassified

“…Saçlı deri tutulumuna SLE aktivitesini gösteren "lupus saçı" maddesi ilave edilmiştir. Hasar skoruna ise dispigmentasyon maddesi genişletilerek hipo/hiperpigmentasyon olmak üzere iki alt başlık eklenmiş; skar oluşumu başlangıç, ciddi skar ve lipoatrofi olarak gruplandırılmıştır 1 . KLASİ ilk kez 9 lupus hastası üzerinde uygulanmış ve ortalama aktivite skoru 11 ve hasar skoru 11 olarak hesaplanmıştır 9 Deri lezyonları arttıkça hastalık ciddiyeti de artmaktadır 14 .…”

Section: Discussionunclassified

“…Lupus eritematozus (LE), deri ve diğer organ tutulumlarıyla giden, kronik seyirli, inflamatuvar ve otoimmün bir hastalık grubudur 1 . Bu spektrumun bir ucunda, hayatı tehdit ederek sistemik tutulumlarla giden sistemik lupus eritematozus (SLE), diğer ucunda ise deri tutulumunun ön planda olduğu subakut kutane lupus eritematozus (SKLE) ve diskoid lupus eritematozus (DLE) yer alır 2 .…”

Section: Introductionunclassified

“…Tedavi değişikliklerinde, tedavinin etkilerini takip etmek amacıyla da kullanılabilmektedir [10][11][12][13] . Öte yandan KLASİ, deri bulgularını daha iyi yansıtması amacıyla 2010 yılında tekrar gözden geçirilmiş ve hem aktivite hem de hasar skoruna yeni parametreler ilave edilerek RKLASİ olarak güncellenmiştir 1 . Ancak henüz bununla ilgili başka bir çalışma olmadığı gibi İngilizce dışında başka bir dile çevrildiği ile ilgili literatürde bir veri de bulunmamaktadır.…”

Section: Introductionunclassified

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Evaluation of skin lesions of lupus with Turkish revised cutaneous lupus erythematosus disease area and severity index

Ürün¹,

Dönmez²,

Arıcan³

et al. 2014

TURKDERM

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Background and Design:The Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI) is used to evaluate the cutaneous manifestations in patients with lupus erythematosus (LE). In recent years, the Revised Cutaneous Lupus Erythematosus Disease Area and Severity Index (RCLASI) which provides more objective assessment has been developed, but the number of studies utilizing RCLASI are limited. The aim of this study was to increase the clinical use of the RCLASI by translating this scale into Turkish and to evaluate the effects of factors, which affect CLASI, on RCLASI. Materials and Methods: The scale was translated into Turkish by using proper international translation steps. Ninety-three LE patients who were admitted to Trakya University Faculty of Medicine were included in this study. Socio-demographic and clinical characteristics of the patients were recorded. Cutaneous manifestations were calculated using RCLASI. Two scores were obtained: activity and damage scores. The relationship of the scores with patient age, gender, duration of illness, facial involvement, subtypes of LE, and antinuclear antibody, Anti-Ro/ SS-A antibody and Anti-La/SS-B antibody positivities were evaluated. Results: The mean activity and damage scores were 2.59±2.88 and 0.81±1.88, respectively. When activity and damage scores were compared between the age groups, there was no statistically significant difference. The damage scores were significantly higher in male patients than in female patients. The activity scores were statistically significantly higher in patients with disease duration of more than three years and facial involvement. There was no statistically significant difference between the subtypes of LE and the activity and damage scores. RCLASI damage scores were statistically significantly higher in Anti-La/SS-B antibody positive patients.

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Low Blood Concentration of Hydroxychloroquine in Patients With Refractory Cutaneous Lupus Erythematosus

Françès

Cosnes²,

Duhaut³

et al. 2012

Arch Dermatol

133

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To study the relation between blood concentration of hydroxychloroquine and the clinical efficacy of hydroxychloroquine sulfate in a series of patients with cutaneous lupus erythematosus (CLE).Design: Prospective multicenter study. A staff dermatologist blinded to blood hydroxychloroquine concentrations performed a standardized review of medical records and assessment of hydroxychloroquine efficacy in the following 3 categories: complete remission, partial remission (clearing of Ͼ50% of skin lesions), or treatment failure. Whole-blood samples were collected for measurement of blood hydroxychloroquine concentration.Setting: Fourteen French university hospitals.Patients: Three hundred consecutive patients with subacute or chronic CLE who had been treated with hydroxychloroquine for at least 3 months. Main Outcome Measures:The statistical significance of correlation between blood hydroxychloroquine concentration and efficacy of hydroxychloroquine and the sta-tistical associations in univariate and multivariate analyses of complete remission with several variables. Results:The study included 300 patients with discoid lupus erythematosus (n=160), subacute CLE (n=86), lupus erythematosus tumidus (n = 52), chilblain lupus (n=26), and lupus panniculitis (n=16); 38 of these patients had 2 or more associated forms. Median blood hydroxychloroquine concentration was significantly higher in patients with complete remission (910 [range, Ͻ50 to 3057] ng/mL) compared with partial remission (692 [Ͻ50 to 2843] ng/mL) and treatment failure (569 [Ͻ50 to 2242] ng/mL) (P=.007). In the multivariate analysis, complete remission was associated with higher blood hydroxychloroquine concentrations (P=.005) and the absence of discoid lesions (P=.004). Thirty patients (10.0%) had very low blood hydroxychloroquine concentrations (Ͻ200 ng/mL) and may be considered nonadherent to the treatment regimen. Conclusion:Monitoring hydroxychloroquine blood concentrations might improve the management of refractory CLE.

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Revised Cutaneous Lupus Erythematosus Disease Area and Severity Index (RCLASI): a modified outcome instrument for cutaneous lupus erythematosus

Cited by 107 publications

References 15 publications

Clinical characteristics of cutaneous lupus erythematosus

Clinical characteristics of cutaneous lupus erythematosus

Evaluation of skin lesions of lupus with Turkish revised cutaneous lupus erythematosus disease area and severity index

Low Blood Concentration of Hydroxychloroquine in Patients With Refractory Cutaneous Lupus Erythematosus

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