Smoking, Severity of Cutaneous Lupus Erythematosus, and Response to Therapy — What's the Right Answer?

In this most recent study, current smokers were more likely to have severe disease that was less responsive to antimalarials.

Open-label observational studies have suggested that antimalarial agents are less effective in tobacco smokers with cutaneous lupus erythematosus (CLE). However, the mechanism is not known, and the disease might be worse in smokers than in nonsmokers. Several studies on which I have commented have upheld these observations, but a recent study questioned this conclusion (JW Dermatol Sep 16 2011).

Now, authors with access to a large cohort of CLE patients have prospectively applied the Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI), a validated scoring system, to measure the relationship between smoking and lupus in 218 patients with systemic or cutaneous LE. Current smokers had higher median CLASI scores (9.5) than did …

Reviewing Author

Jeffrey P. Callen, MD

Disclosures

Consultant / Advisory board XOMA; Eli Lilly; Celgene

Equity Various trust accounts

Editorial boards JAMA Dermatology; UpToDate

Leadership positions in professional societies Association of Professors of Dermatology (President-Elect)