Dermatology, The University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Population and Data Sciences, The University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Lupus Sci Med. 2021 Nov;8(1). doi: 10.1136/lupus-2021-000514.
Epidemiological studies have shown that discoid lupus erythematosus (DLE) has a higher incidence and prevalence in racial/ethnic minority groups, particularly Black individuals. The objective of this retrospective cohort study was to identify the differences in DLE lesion distribution and characteristics in Black individuals compared with non-Black individuals.
183 patients with DLE (112 Black patients and 71 non-Black patients) with a reported race/ethnicity and Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI) scores were included in this retrospective cohort study. Univariate analysis was performed to determine significant differences in demographic data, clinical characteristics, DLE lesion distribution and DLE lesion characteristics in Black and non-Black patients with DLE. Multivariable logistic regression was preformed to determine significant predictors of DLE lesion location and characteristics.
Black patients with DLE had worse baseline CLASI damage scores compared with non-Black patients with DLE (median (IQR): 10.0 (6.0-14.5) vs 6.0 (3.0-10.0), p<0.001) and had 48.9 greater odds of dyspigmentation in any anatomical location (p<0.001). Black patients had 2.54 greater odds of having scalp involvement (p=0.015) and 1.97 greater odds of having ear involvement (p=0.032) compared with non-Black patients. Black patients also had greater odds of scalp dyspigmentation (OR=5.85, p<0.001), ear dyspigmentation (OR=2.89, p=0.001) and scarring alopecia (OR=3.00, p=0.001) compared with non-Black patients.
Signs of disease damage, particularly ear dyspigmentation, scalp dyspigmentation and scarring alopecia, can more frequently affect Black patients with DLE. Recognising differences in clinical presentation of DLE among Black patients can assist future efforts with understanding biological, cultural, psychosocial and systemic factors that influence DLE presentation and outcomes in Black patients and may guide clinicians when counselling Black patients.
流行病学研究表明，盘状红斑狼疮（DLE）在种族/少数民族群体中的发病率和患病率较高，尤其是黑人。本回顾性队列研究的目的是确定与非黑人相比，黑人个体中 DLE 病变分布和特征的差异。
本回顾性队列研究纳入了 183 名报告种族/民族和皮肤狼疮红斑疾病面积和严重程度指数（CLASI）评分的 DLE 患者（112 名黑人患者和 71 名非黑人患者）。进行单因素分析，以确定 DLE 患者的人口统计学数据、临床特征、DLE 病变分布和 DLE 病变特征方面的显著差异。进行多变量逻辑回归分析，以确定 DLE 病变位置和特征的显著预测因子。
与非黑人 DLE 患者相比，黑人 DLE 患者的基线 CLASI 损害评分更差（中位数（IQR）：10.0（6.0-14.5）比 6.0（3.0-10.0），p<0.001），任何解剖部位色素沉着异常的可能性高 48.9%（p<0.001）。与非黑人患者相比，黑人患者头皮受累的可能性高 2.54 倍（p=0.015），耳部受累的可能性高 1.97 倍（p=0.032）。黑人患者头皮色素沉着异常（OR=5.85，p<0.001）、耳部色素沉着异常（OR=2.89，p=0.001）和瘢痕性脱发（OR=3.00，p=0.001）的可能性也高于非黑人患者。
疾病损害的迹象，特别是耳部色素沉着异常、头皮色素沉着异常和瘢痕性脱发，更常影响黑人 DLE 患者。认识到黑人 DLE 患者临床表现的差异有助于未来努力了解影响黑人患者 DLE 表现和结局的生物学、文化、心理社会和系统性因素，并可能指导临床医生在为黑人患者提供咨询时。
