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J Am Acad Dermatol ; 90(6): 1210-1217, 2024 Jun.
Article En | MEDLINE | ID: mdl-38301924

BACKGROUND: Cutaneous lupus erythematosus (CLE) may present as an isolated entity or be classified as Systemic lupus erythematosus (SLE) by the presence of laboratory abnormalities, including cytopenia, low complement levels, and/or autoantibodies (CLE with laboratory SLE). OBJECTIVE: To compare isolated CLE and CLE with laboratory SLE and to validate an existing 3-item score with age < 25 years (1 point), phototypes V to VI (1 point), antinuclear antibodies ≥ 1:320 (5 points) to predict the risk of progression from CLE to severe SLE (sSLE). METHODS: Monocentric cohort study including consecutive patients with CLE. CLE with laboratory SLE was defined by 2019 American College of Rheumatology/European League Against Rheumatism classification criteria for SLE score of ≥10 points at baseline with CLE as the sole clinical feature. RESULTS: Of the 149 patients with CLE, 20 had CLE with laboratory SLE. The median follow-up duration was 11.3 years (IQR: 5.1-20.5). Ten patients (7%) had sSLE developed. In survival analysis, the risk of progression to sSLE was higher among CLE with laboratory SLE (hazard ratio = 6.69; 95% CI: 1.93-23.14, P < .001) compared to isolated CLE. In both groups, none of the patients with a risk score ≤ 2 had sSLE developed. LIMITATIONS: Monocentric study with a limited number of patients. CONCLUSIONS: CLE with laboratory patients with SLE have a higher risk of progression to sSLE than isolated CLE.


Disease Progression , Lupus Erythematosus, Cutaneous , Lupus Erythematosus, Systemic , Humans , Lupus Erythematosus, Cutaneous/diagnosis , Lupus Erythematosus, Cutaneous/complications , Lupus Erythematosus, Cutaneous/immunology , Lupus Erythematosus, Cutaneous/pathology , Female , Adult , Male , Lupus Erythematosus, Systemic/complications , Lupus Erythematosus, Systemic/diagnosis , Middle Aged , Antibodies, Antinuclear/blood , Antibodies, Antinuclear/immunology , Severity of Illness Index , Young Adult , Retrospective Studies , Follow-Up Studies , Cohort Studies
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