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Abstract Number: 947

The Impact of Dyspigmentation and Scarring in Cutaneous Lupus On Quality of Life

Saroj M. Verma1, Joyce Okawa2, Kathleen Propert3 and Victoria P. Werth4, 1Dermatology, University of Pennsylvania, Philadelphia, PA, 2Department of Dermatology, Perelman School of Medicine at the University of Pennsylvania and Philadelphia V.A. Medical Center, Philadelphia, PA, 3Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, PA, 4Department of Dermatology, Veteran Affairs Medical Center, Philadelphia, PA

Meeting: 2012 ACR/ARHP Annual Meeting

Keywords: Cutaneous lupus erythematosus, health disparities, quality of life and race/ethnicity

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Session Information

Session Title: Epidemiology and Health Services Research: Epidemiology and Outcomes of Rheumatic Disease II

Session Type: Abstract Submissions (ACR)

Background/Purpose: Patients with more severe cutaneous lupus activity have poorer quality of life. The main objective of the current study was to evaluate the impact that lupus-related disease damage had on skin-specific quality of life and the differences observed within a population of CLE patients from different racial backgrounds with respect to disease damage and its impact on quality of life. 

Methods: Patients were enrolled into our prospective database and evaluated with a validated cutaneous lupus-scoring tool (CLASI). Data collected included sex, race, diagnosis, Cutaneous Lupus Area Activity and Severity Index (CLASI) scores, and Skindex-29 QoL scores. These parameters were analyzed at the initial and last visits. CLASI damage scores (dyspigmentation and scarring) and CLASI activity scores were collected, grouped by race, and correlated with Skindex-29 domains. 

Results: 223 patients were analyzed at baseline, with 141 of these patients completing more than one study visit. The majority of patients were Caucasians (63.7%), followed by African Americans (29.1%) and Asian Americans (4.0%). African Americans accounted for a disproportionate percentage of both localized (50% of cases) and generalized (48.9% of cases) DLE. Median CLASI damage scores significantly differed between African Americans, Caucasians, and Asian Americans, at both first (8.5, 4.0, 7.0) (Kruskal-Wallis p<0.0001) and last visit (10.0, 6.0, 8.5) (Kruskal-Wallis p<0.01), (Dunn’s Multiple Comparison p<0.0001, p<0.01). CLASI damage scores in African Americans correlated with CLASI activity scores (Spearman’s r=0.45, p=0.0003). There was no significant correlation between CLASI damage scores and Skindex domains overall. Individually, dyspigmentation and scarring also did not have a significant effect on Quality of Life.

Conclusion: In conclusion, disease damage does not affect quality of life, as measured by the Skindex-29.  Differences were found in CLE patients of different races: African American patients with CLE, do exhibit a high rate of DLE, experience damage early in their disease course, frequently in conjunction with disease activity


Disclosure:

S. M. Verma,
None;

J. Okawa,
None;

K. Propert,
None;

V. P. Werth,
None.

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