Association of discoid lupus erythematosus with clinical manifestations and damage accrual in a multiethnic lupus cohort
Article first published online: 23 APR 2012
Copyright © 2012 by the American College of Rheumatology
Arthritis Care & Research
Volume 64, Issue 5, pages 704–712, May 2012
How to Cite
Santiago-Casas, Y., Vilá, L. M., McGwin, G., Cantor, R. S., Petri, M., Ramsey-Goldman, R., Reveille, J. D., Kimberly, R. P., Alarcón, G. S. and Brown, E. E. (2012), Association of discoid lupus erythematosus with clinical manifestations and damage accrual in a multiethnic lupus cohort. Arthritis Care Res, 64: 704–712. doi: 10.1002/acr.21581
- Issue published online: 2 APR 2012
- Article first published online: 23 APR 2012
- Accepted manuscript online: 20 DEC 2011 02:56PM EST
- Manuscript Accepted: 15 DEC 2011
- Manuscript Received: 7 OCT 2011
- National Institute of Arthritis and Musculoskeletal and Skin Diseases. Grant Number: P01AR49084
- University of Alabama at Birmingham [UAB]
- Johns Hopkins University [JHU]
- Northwestern University [NU]
- University of Puerto Rico [UPR]
- University of Texas Health Science Center at Houston [UTH]. Grant Numbers: AR43727, R01-AR42503, K24-AR002138, P60AR048098, R01-AR42503
- General Clinical Research Centers. Grant Numbers: M01-RR00052, M01-RR00032, M01-RR00048, M01-RR02558
- National Center for Research Resources/NIH. Grant Number: 1U54RR026139-01A1
To determine the clinical manifestations and disease damage associated with discoid rash in a large multiethnic systemic lupus erythematosus (SLE) cohort.
SLE patients (per American College of Rheumatology [ACR] criteria) ages ≥16 years with a disease duration of ≤10 years at enrollment and defined ethnicity (African American, Hispanic, or white) from a longitudinal cohort were studied. Socioeconomic–demographic features, clinical manifestations, and disease damage (per the Systemic Lupus International Collaborating Clinics/ACR Damage Index) were determined. The association of discoid lupus erythematosus (DLE) with clinical manifestations and disease damage was examined using multivariable logistic regression.
A total of 2,228 SLE patients were studied. The mean ± SD age at diagnosis was 34.3 ± 12.8 years and the mean ± SD disease duration was 7.9 ± 6.0 years; 91.8% were women. DLE was observed in 393 patients with SLE (17.6%). In the multivariable analysis, patients with DLE were more likely to be smokers and of African American ethnicity and to have malar rash, photosensitivity, oral ulcers, leukopenia, and vasculitis. DLE patients were less likely to be of Hispanic (from Texas) ethnicity and to have arthritis, end-stage renal disease, and antinuclear, anti–double-stranded DNA, and antiphospholipid antibodies. Patients with DLE had more damage accrual, particularly chronic seizures, scarring alopecia, scarring of the skin, and skin ulcers.
In this cohort of SLE patients, DLE was associated with several clinical features, including serious manifestations such as vasculitis and chronic seizures.