Ker Khor Jia, Teske Noelle M, Feng Rui, Chong Benjamin F, Werth Victoria P
National Skin Centre, Singapore, Singapore; Department of Dermatology, University of Pennsylvania, Philadelphia, Pennsylvania.
Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, Texas.
J Am Acad Dermatol. 2018 Dec;79(6):1053-1060.e3. doi: 10.1016/j.jaad.2018.06.040. Epub 2018 Jun 30.
Long-term studies characterizing disease course of cutaneous lupus erythematosus (CLE) patients on standard-of-care treatments are lacking.
We characterized and compared disease course of CLE patients using Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI).
In total, 83 CLE patients with CLASI scores collected from ≥3 study visits within 2 years had disease activity and damage trends calculated by average change scores (ACS). Trends were classified as improved (ACS ≤-3), worsened (ACS ≥3), or stable (-3 < ACS < 3). Linear regression models compared CLASI trends between groups.
Most patients (72.73%) with initial CLASI activity (CLASI-A) scores >9 (N = 33) had improved disease activity versus 14.00% of those with initial CLASI-A scores ≤9 (N = 50). Linear regression analyses showed significant improvement in CLASI-A scores in patients of minority races (P < .05), with baseline CLASI-A scores >9 (P < .0001), baseline CLASI damage (CLASI-D) scores ≥10 (P = .0001), and CLE disease duration ≤1 year (P = .01). Of 28 patients with baseline CLASI-D scores ≥10, 35.71% had improvements in damage, while 5.26% of patients with initial CLASI-D scores of 5-9 (N = 19) and 0% with initial CLASI-D scores <5 (N = 36) (P = .0005) had improvements.
Limitations include small sample size.
Baseline CLASI-A score >9, minority race, and short disease duration predict CLE disease activity improvement. A baseline CLASI-D score ≥10 is associated with disease damage improvement.
缺乏关于接受标准治疗的皮肤红斑狼疮（CLE）患者疾病进程的长期研究。
我们使用皮肤红斑狼疮疾病面积和严重程度指数（CLASI）对CLE患者的疾病进程进行了特征描述和比较。
共有83例在2年内≥3次研究访视时收集了CLASI评分的CLE患者，通过平均变化评分（ACS）计算疾病活动度和损伤趋势。趋势分为改善（ACS≤-3）、恶化（ACS≥3）或稳定（-3＜ACS＜3）。线性回归模型比较了各组之间的CLASI趋势。
初始CLASI活动度（CLASI-A）评分＞9（N = 33）的大多数患者（72.73%）疾病活动度得到改善，而初始CLASI-A评分≤9（N = 50）的患者中这一比例为14.00%。线性回归分析显示，少数族裔患者（P＜0.05）、基线CLASI-A评分＞9（P＜0.0001）、基线CLASI损伤（CLASI-D）评分≥10（P = 0.0001）以及CLE病程≤1年（P = 0.01）的患者，其CLASI-A评分有显著改善。在28例基线CLASI-D评分≥10的患者中，35.71%的患者损伤得到改善，而初始CLASI-D评分为5-9（N = 19）的患者中有5.26%得到改善，初始CLASI-D评分＜5（N = 36）的患者中改善比例为0%（P = 0.0005）。
局限性包括样本量小。
基线CLASI-A评分＞9、少数族裔以及疾病病程短可预测CLE疾病活动度改善。基线CLASI-D评分≥10与疾病损伤改善相关。
