Session Information
Session Type: Abstract Submissions (ACR)
Background/Purpose: Panniculitis is a rare, but devastating manifestation of SLE. We examined associates of panniculitis in a large SLE cohort.
Methods: 52 out of 2,149 SLE patients in the cohort had panniculitis (2.4%). The mean age at last assessment was 49±15 years. The patients were 46% African-American, 46% Caucasian, and 96% female. Other SLE manifestations were determined at baseline by history, physical examination, and chart review; patients were then seen quarterly in follow-up.
Results:
The table shows the association of demographics, SLE manifestations and serologies with panniculitis. Panniculitis was strongly associated with discoid lupus and leg ulcers. It was also associated with serositis, seizures, myositis, alopecia, and vasculitis. Proteinuria was significantly less frequent in those with panniculitis.
Association between Various Factors and Panniculitis in SLE
|
Characteristics/ Manifestations |
Panniculitis (%, N=52) |
No panniculitis (%, N=2097) |
Odds Ratio (95% CI) |
Adjusted P-value§ |
|
History of smoking |
48.1 |
37.8 |
1.3 (0.7, 2.3) |
0.34 |
|
Disability |
40.4 |
21.8 |
2.1 (1.1, 3.7) |
0.016 |
|
Malar rash |
57.7 |
51.0 |
1.3 (0.7, 2.3) |
0.41 |
|
Discoid |
50.0 |
19.0 |
3.8 (2.1, 6.9) |
<.0001 |
|
Photosensitivity |
63.5 |
53.7 |
1.4 (0.8, 2.6) |
0.22 |
|
Mouth ulcers |
61.5 |
51.2 |
1.5 (0.9, 2.7) |
0.15 |
|
Arthritis |
80.8 |
73.5 |
1.2 (0.6, 2.5) |
0.57 |
|
Serositis |
67.3 |
48.9 |
2.0 (1.1, 3.7) |
0.020 |
|
Proteinuria |
28.9 |
44.3 |
0.4 (0.2, 0.8) |
0.0062 |
|
Hematologic disorder |
75.0 |
65.7 |
1.4 (0.8, 2.7) |
0.27 |
|
ANA positivity |
98.1 |
96.5 |
1.7 (0.2, 12.8) |
0.59 |
|
Myositis |
19.2 |
7.7 |
2.3 (1.1, 4.9) |
0.023 |
|
Alopecia |
73.1 |
53.1 |
2.0 (1.0, 3.8) |
0.040 |
|
Vasculitis |
28.9 |
14.2 |
2.2 (1.2, 4.2) |
0.012 |
|
Leg ulcers |
17.3 |
2.5 |
7.1 (3.2, 15.7) |
<.0001 |
|
Seizure |
19.2 |
9.5 |
2.4 (1.2, 4.8) |
0.019 |
|
Peripheral Neuropathy |
11.5 |
3.7 |
2.5 (1.0, 6.4) |
0.046 |
|
Leukopenia |
59.6 |
43.9 |
1.8 (1.0, 3.2) |
0.044 |
|
Lupus Anticoagulant |
26.0 |
27.2 |
0.9 (0.5, 1.7) |
0.73 |
|
Low C3 |
46.2 |
55.6 |
0.6 (0.4, 1.1) |
0.12 |
|
Low C4 |
36.5 |
48.3 |
0.6 (0.3, 1.1) |
0.10 |
|
Increased ESR |
82.7 |
74.9 |
1.4 (0.6, 3.0) |
0.41 |
|
Anti- Sm |
11.5 |
19.4 |
0.6 (0.2, 1.4) |
0.20 |
|
Anti-DNA |
63.5 |
63.0 |
1.0 (0.5, 1.7) |
0.88 |
|
Anti-Ro |
38.5 |
30.6 |
1.4 (0.8, 2.6) |
0.21 |
|
Anti-La |
15.4 |
12.9 |
1.3 (0.6, 2.8) |
0.52 |
§ Adjusted for ethnicity, gender, age at last assessment, and duration of SLE at last assessment
Conclusion: In contrast to photosensitive cutaneous lupus, panniculitis is not associated with anti-Ro, anti-La, or smoking. It is strongly associated with discoid (discoid lesions often overlay panniculitis areas). It is not associated with any serologic test, and, in fact, is less frequent in those with renal lupus. The impact of panniculitis has been unrecognized, with 40% becoming disabled due to it.
Disclosure:
A. Odhav,
None;
M. Petri,
None;
H. Fang,
None.
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