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1Department of Dermatology and Venereology, Faculty of Medicine, Universitas Brawijaya – RSUD dr. Saiful Anwar Malang, Indonesia
2Rheumatology Division, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya – RSUD dr. Saiful Anwar Malang, Indonesia
Herwinda Brahmanti
, Cesarius Singgih Wahono, Mirza Zaka Pratama, Perdana Aditya Rahman, Riski Bagus Suhendra, Amalia Novia Rizky, Nabilah Hanifah Mukti
Background: Cutaneous involvement is common in systemic lupus erythematosus (SLE) patients and may be essential to the disease activity. This study aimed to describe cutaneous manifestations spectrum and determine the association of cutaneous lesions with the disease activity and systemic involvement among SLE patients in Malang, Indonesia. Methods: A cross-sectional study was conducted using 54 SLE patients from rheumatology outpatient clinic at Saiful Anwar General Hospital Malang, Indonesia. Cutaneous features were classified according to Gilliam and Sontheimer classification of cutaneous lupus. Disease activity and clinical manifestations were documented according to Mexican-SLE disease activity index (Mex-SLEDAI). Results: Among 54 subjects, 50% of the patients had cutaneous manifestations. Subacute cutaneous lupus erythematosus (SCLE) was observed in 11.1% of patients, and malar rash in 20.4%. Subjects with cutaneous lesions had significantly higher Mex-SLEDAI scores, especially those who had SCLE (p<0.001), malar rash (p=0.002), alopecia (p=0.002), and photosensitivity (p=0.032). Six patients (11.1%) had skin infections with higher disease activity (9[8–11]vs.2[0–4];p<0.001). SCLE was significantly associated with malar rash (OR 11.7[1.8–76.5]), vasculitis (OR 43.0[4.1–445.6]), and fatigue (OR 15.0[2.1–108.8]). Malar rash was associated with photosensitivity (OR 8.4[1.6–44.0]), while oral or nasal ulcer was associated with fatigue (OR 8.6 [1.4 –54.6]). Vasculitis (OR 5.9[1.0–35.1]) and nephritis (OR 11.7 [1.8–76.5]) were associated with the presence of skin infection. Conclusion: SCLE and malar rash are the most common cutaneous lesions among subjects. Subjects with cutaneous lesions have relatively higher disease activity. Several skin lesions are also associated with SLE patients' systemic manifestations.
Cite this article as: Brahmanti H, Wahono CS, Pratama MZ, Rahman PA, Suhendra RB, Rizky AN, Mukti NH. Association of the Spectrum of Cutaneous Lupus Erythematosus with Disease Activity and Systemic Manifestations in Patients with Systemic Lupus Erythematosus. Mediterr J Rheumatol 2024;35(1):143-9.
Article Submitted: 20 Apr 2023; Revised Form: 5 Jul 2023; Article Accepted: 10 Sep 2023; Available Online: 19 Sep 2023
https://doi.org/10.31138/mjr.200423.aos
This work is licensed under a Creative Commons Attribution 4.0 International License.
©2024 The Author(s).
