ABSTRACT
OBJECTIVE: The objective of this study was to assess the risk and prevalence of oral cancer in patients with systemic lupus erythematosus (SLE) or discoid lupus erythematosus (DLE). STUDY DESIGN: The review included observational cohort and cross-sectional studies that investigated the incidence or prevalence of oral cancer in adults with confirmed diagnoses of SLE or DLE. Studies were selected based on predefined eligibility criteria, including the use of specific diagnostic criteria for SLE and DLE. After searches in PubMed/MEDLINE, EMBASE, Scopus, Web of Science, LILACS, and LIVIVO databases and gray literature for relevant studies, the selection process was conducted by independent reviewers. RESULTS: A total of 5,545 articles were identified. After screening, 8 studies met the inclusion criteria. The pooled risk estimate indicated a significantly increased risk of oral cancer in patients with SLE (risk ratio = 2.69; 95% confidence interval, 1.75 to 4.16; I2 = 0%; P = .78) compared with the general population. The pooled prevalence of oral cancer in patients with DLE was 10% (95% ci, 0.03 to 0.13; I2 = 59%; P = .12). CONCLUSIONS: This review provides evidence supporting an elevated risk for individuals with SLE or DLE developing oral cancer. The findings highlight the importance of monitoring oral mucosa in patients with these conditions.
Subject(s)
Lupus Erythematosus, Discoid , Lupus Erythematosus, Systemic , Mouth Neoplasms , Adult , Humans , Cross-Sectional Studies , Prevalence , Lupus Erythematosus, Systemic/complications , Lupus Erythematosus, Systemic/epidemiology , Lupus Erythematosus, Systemic/diagnosis , Lupus Erythematosus, Discoid/complications , Lupus Erythematosus, Discoid/epidemiology , Mouth Neoplasms/epidemiologyABSTRACT
OBJECTIVES: This study aimed to compare the clinical features, damage accrual, and survival of patients with familial and sporadic systemic lupus erythematosus (SLE). METHODS: A multi-ethnic, multinational Latin American SLE cohort was studied. Familial lupus was defined as patients with a first-degree SLE relative; these relatives were interviewed in person or by telephone. Clinical variables, disease activity, damage, and mortality were compared. Odds ratios (OR) and 95% confidence intervals (CI) were estimated. Hazard ratios (HR) were calculated using Cox proportional hazard adjusted for potential confounders for time to damage and mortality. RESULTS: A total of 66 (5.6%) patients had familial lupus, and 1110 (94.4%) had sporadic lupus. Both groups were predominantly female, of comparable age, and of similar ethnic distribution. Discoid lupus (OR = 1.97; 95% CI 1.08-3.60) and neurologic disorder (OR = 1.65; 95% CI 1.00-2.73) were significantly associated with familial SLE; pericarditis was negatively associated (OR = 0.35; 95% CI 0.14-0.87). The SLE Disease Activity Index and Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI) were similar in both groups, although the neuropsychiatric (45.4% vs. 33.5%; p = 0.04) and musculoskeletal (6.1% vs. 1.9%; p = 0.02) domains of the SDI were more frequent in familial lupus. They were not retained in the Cox models (by domains). Familial lupus was not significantly associated with damage accrual (HR = 0.69; 95% CI 0.30-1.55) or mortality (HR = 1.23; 95% CI 0.26-4.81). CONCLUSION: Familial SLE is not characterized by a more severe form of disease than sporadic lupus. We also observed that familial SLE has a higher frequency of discoid lupus and neurologic manifestations and a lower frequency of pericarditis.
Subject(s)
Ethnicity , Lupus Erythematosus, Systemic/mortality , Adolescent , Adult , Age Factors , Child , Cohort Studies , Disease Progression , Female , Humans , Latin America/epidemiology , Lupus Erythematosus, Discoid/epidemiology , Male , Middle Aged , Multivariate Analysis , Pericarditis/epidemiology , Proportional Hazards Models , Severity of Illness Index , Sex Factors , Young AdultABSTRACT
Introducción. El lupus eritematoso (LE) es una enfermedad inflamatoria multisistémica de etiología desconocida que comprende una variedad de formas clínicas. Material y método. Se efectuó un estudio retrospectivo y descriptivo de los pacientes que consultaron en el Servicio de Dermatología del Policlínico Bancario durante el período comprendido entre enero de 1994 y enero de 2009. Se incluyeron aquellos pacientes mayores de 18 años con diagnóstico histopatológico de lupus eritematoso. Objetivos. Identificar las distintas variantes clínicas de lupus eritematoso, establecer su distribución por sexo y edad, y comparar los resultados con las estadísticas nacionales e internacionales. Resultados. Se evaluaron 46 pacientes (33 mujeres [71,73%]).Edad promedio al diagnóstico: 42 años; rango: 19-70 años. Presentaron lesiones específicas de LE 42 pacientes (91,30%), 28 correspondieron a la variante de lupus eritematoso cutáneo crónico (67%), 6 a lupus eritematoso cutáneo subagudo (14%) y 8 a lupus eritematoso cutáneo agudo (19%). Las lesiones inespecíficas se presentaron en 21 pacientes (45%) y las halladas con mayor frecuencia fueron: fotosensibilidad (38,09%) alopecia difusa (33,33%) y alteraciones vasculares (28,57%). Conclusión. Nuestros hallazgos son similares a los señalados en la bibliografía consultada, a excepción de la edad de presentación, que fue superior.
Subject(s)
Humans , Lupus Erythematosus, Cutaneous/classification , Lupus Erythematosus, Cutaneous/epidemiology , Lupus Erythematosus, Discoid/classification , Lupus Erythematosus, Discoid/epidemiology , Skin Diseases/etiologyABSTRACT
OBJECTIVE: To retrospectively study the incidence of chronic cutaneous lupus erythematosus (CCLE) in French Guiana (FG), South America, during the period 1995-1999. METHODS: Private and public physicians specializing in dermatology, rheumatology, and internal medicine were asked during the year 2000 about lupus cases. We reviewed hospitals' files in data-processing departments. RESULTS: Twenty new cases of CCLE, mostly discoid form, were identified during this 5-year period in this population of predominantly African descent. The average annual incidence of the disease was 2.59 per 100,000 inhabitants (95% confidence interval 1.5-4). However, our methodology could introduce underestimation of the incidence of the disease. CONCLUSION: The average annual incidence of CCLE in FG appears to be low in this retrospective study, but is very similar to the only previously published data in the US.
Subject(s)
Lupus Erythematosus, Discoid/epidemiology , Adolescent , Adult , Black People/statistics & numerical data , Child , Female , French Guiana/epidemiology , Humans , Male , Retrospective Studies , Young AdultABSTRACT
Discoid lupus erythematosus is much less frequent and studied in children. We undertook a retrospective study of 34 children less than 16 years of age with this disease, seen over a period of 9 years. A female predominance of 2:1 was found. An association between discoid lupus erythematosus and systemic lupus erythematosus was observed in 23.5% of patients, a higher proportion compared to adult discoid lupus erythematosus. Disseminated lesions were much more frequent in patients with criteria for systemic lupus erythematosus (87.5% vs 34%), suggesting that it could be associated with a worse prognosis. Histologic findings were similar to those observed in adult discoid lupus erythematosus.
Subject(s)
Lupus Erythematosus, Discoid/diagnosis , Lupus Erythematosus, Discoid/epidemiology , Adolescent , Age Distribution , Age of Onset , Child , Child, Preschool , Female , Follow-Up Studies , Humans , Infant , Lupus Erythematosus, Discoid/genetics , Lupus Erythematosus, Discoid/pathology , Male , Medical History Taking , Retrospective Studies , Sex Distribution , Skin/pathologyABSTRACT
BACKGROUND: Discoid lupus erythematosus (DLE) is a chronic cutaneous disease affecting photoexposed areas and has also been associated with cigarette smoking. OBJECTIVE: To evaluate the association between smoking and DLE. METHODS: A case-control study was performed involving 57 cases diagnosed with DLE and 215 healthy controls. RESULTS: A higher smoking prevalence was noted in DLE cases (84.2%) than controls (33.5%), and the odds ratio adjusted for gender, age and ultraviolet index in the city of origin was 14.4 (95% confidence interval 6.2-33.8; multiple logistic regression, p < 0.01). The cumulative smoking exposure was not related to premature DLE development. At the beginning of the disease, smokers had more extensive involvement than nonsmokers; compromise of the upper arms was statistically related to smoking. CONCLUSION: Cigarette smoking was statistically associated with DLE development. Other studies are needed in order to evaluate the effects of smoking cessation on the course of disease.
Subject(s)
Lupus Erythematosus, Discoid/diagnosis , Lupus Erythematosus, Discoid/epidemiology , Smoking/adverse effects , Smoking/epidemiology , Adolescent , Adult , Age Distribution , Case-Control Studies , Comorbidity , Female , Humans , Incidence , Logistic Models , Lupus Erythematosus, Discoid/etiology , Male , Middle Aged , Multivariate Analysis , Odds Ratio , Probability , Prognosis , Reference Values , Risk Assessment , Severity of Illness Index , Sex DistributionABSTRACT
BACKGROUND: Hypertrophic lupus erythematosus (HLE) is a distinct and rare subset of lupus erythematosus (LE). It is characterized by verrucous lesions, chronic in its course, and resistant to treatment. The purpose of this study was to identify clinical and histological characteristics of HLE. METHODS: We review our experience with 14 cases of HLE identified in a group of 220 patients with different forms of LE, at the UNICAMP Hospital, between 1976 and 2002. RESULTS: All patients presented verrucous plaques concomitantly with discoid lesions. The most common sites of involvement were the face and the arms. Histology of HLE lesions revealed pseudoepitheliomatous hyperplasia engulfing elastotic material. Elastic fibers were seen in migration throughout the epidermis. Classic features of LE were noted in all cases. Three of the patients developed hyperkeratotic papules with central keratinous plug on their arms at the previous LE sites. These lesions resemble clinically and histopathologically keratoacanthomas. In one patient, HLE lesion progressed to squamous cell carcinoma (SCC), 26 years after the onset of the disease. CONCLUSIONS: Transepithelial elimination of the elastotic material may be a feature of HLE. Some HLE lesions may present as keratoacanthoma, but classical features of LE aid the correct diagnosis. SCC may arise on a long-standing HLE lesion; therefore HLE requires clinical and histopathological follow up.
Subject(s)
Lupus Erythematosus, Discoid/pathology , Skin/pathology , Adult , Brazil/epidemiology , Female , Follow-Up Studies , Hospitals, University , Humans , Hyperplasia , Hypertrophy , Lupus Erythematosus, Discoid/complications , Lupus Erythematosus, Discoid/epidemiology , Male , Middle Aged , Retrospective StudiesABSTRACT
Among 27 pediatric patients with a clinicopathologic diagnosis of discoid lupus erythematosus (DLE), 15 had localized cutaneous lesions and 12 had disseminated lesions. During a mean follow-up period of 36 months, seven patients (26%) developed systemic lupus erythematosus (SLE). Four of these patients were less than 10 years of age. No correlation was found between localized and disseminated lesions and evolution to SLE. Three of four patients with a positive family history for rheumatoid disease developed SLE (p < 0.05). Hyperpigmentation was significantly more frequent (p < 0.04) in children less than 10 years of age. There was a female predominance of 5:1 among patients less than 10 years of age. Our findings suggest that onset of DLE prior to 10 years of age does not indicate a greater risk of developing SLE. The occurrence of localized or disseminated lesions does not seem to influence the outcome.
Subject(s)
Lupus Erythematosus, Discoid/epidemiology , Lupus Erythematosus, Discoid/pathology , Adolescent , Age Distribution , Biopsy, Needle , Child , Child, Preschool , Cohort Studies , Disease Progression , Female , Follow-Up Studies , Humans , Immunohistochemistry , Immunosuppressive Agents/therapeutic use , Incidence , Lupus Erythematosus, Discoid/drug therapy , Lupus Erythematosus, Systemic/drug therapy , Lupus Erythematosus, Systemic/epidemiology , Lupus Erythematosus, Systemic/pathology , Male , Mexico/epidemiology , Probability , Retrospective Studies , Severity of Illness Index , Sex Distribution , Treatment OutcomeSubject(s)
Tropical Climate , Dermatitis/epidemiology , Dermatomycoses/epidemiology , Skin Diseases/epidemiology , Eczema/epidemiology , Scleroderma, Systemic/epidemiology , Retrospective Studies , Leprosy/epidemiology , Hospitals, University , Lupus Erythematosus, Discoid/epidemiology , Psoriasis/epidemiology , Togo/epidemiology , Tuberculosis, Cutaneous/epidemiologyABSTRACT
Em maio de 1982 foi criado, na Santa Casa de Säo Paulo, Grupo de estudo para acompanhamento de casos de lúpus eritematoso discóide. Após seis anos e meio de atividades, em setembro de 1988, estavam registrados no grupo 171 casos de LED; como no mesmo período foram registrados 61.845 novos doentes no Ambulatório da Clínica Dermatológica, a proporçäo foi de um doente com LED para cada 361 novas consultas. As características do grupo estudado foram as seguintes: A) no início do LED a idade variou entre oito e 57 anos, com média de 36,8 anos; B) o tempo médio decorrido até a primeira consulta foi de 50,3 meses ( o que mostra que a Santa Casa é principalmente procurada por pacientes mais antigos, que näo tiveram sucesso em tratamentos anteriormente realizados; C) a distribuiçäo por sexo foi de 124 mulheres (72,6%) para 47 homens (27,4%), o que dá a proporçäo, aproximadamente, de 3:1; D) quanto à raça, 117 eram brancos (68,4%), 40 pardos (23,3%), 12 negros (7,0) e dois orientais (1,1%); E) apenas sete pacientes (4%) referiam a ocorrência de LED familiar, sendo que um deles tinha dois familiares afetados: irmäo (3), mäe (2), sobrinho (1), avó (1); F) a lesäo inicial esteve principalmente localizada na face ou fronte (120), seguindo-se couro cabeludo (17), orelhas (12), pescoço (9), membros superiores (9), mucosa bucal (2) e lábio (1)
Subject(s)
Child , Adolescent , Adult , Middle Aged , Humans , Male , Female , Lupus Erythematosus, Discoid/epidemiology , Brazil , Lupus Erythematosus, Discoid/geneticsABSTRACT
The child of a woman with discoid lupus erythematosus (DLE) had lesions of DLE develop...