What Does Presence of Discoid Lupus Erythematosus in Patients with Systemic Lupus Erythematosus Imply for Prognosis?

This report reconfirms earlier observations of lower-than-expected rates of end-stage renal disease when DLE lesions are present at diagnosis.

In the late 1970s, my colleagues and I published observational studies suggesting a better prognosis in systemic lupus erythematosus (SLE) patients with discoid LE (DLE). Other researchers have suggested that end-stage renal disease is also less common in such patients. These prior studies evaluated patients with DLE at any time in the course of the patient's disease.

Now, Drucker and colleagues compare 524 SLE patients with and without skin lupus. The study group was taken from a larger cohort of 1781 systematically followed patients with SLE defined by the ACR criteria. Of the 524, 284 had no CLE, 65 had DLE, and 175 had malar rash. Patients with DLE at onset differed little from those without cutaneous disease in adjusted mean activity sc…

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)