Cutaneous lupus erythematosus and its association with systemic lupus erythematosus: A nationwide population‐based cohort study in Korea

Systemic lupus erythematosus (SLE) is a well-known cardiovascular risk factor. Less is known about cutaneous lupus erythematosus (CLE) and the risk of developing cardiovascular disease (CVD). Therefore, we investigated the risk of mortality and adverse cardiovascular events in patients diagnosed with SLE and CLE. We conducted a cohort study of the entire Danish population aged ≥ 18 and ≤ 100 years, followed from 1997 to 2011 by individual-level linkage of nationwide registries. Multivariable adjusted Cox regression models were used to estimate the hazard ratios (HRs) for a composite cardiovascular endpoint and all-cause mortality, for patients with SLE and CLE. A total of 3282 patients with CLE and 3747 patients with SLE were identified and compared with 5,513,739 controls. The overall HR for the composite CVD endpoint was 1.31 (95% CI 1.16–1.49) for CLE and 2.05 (95% CI 1.15–3.44) for SLE. The corresponding HRs for all-cause mortality were 1.32 (95% CI 1.20–1.45) for CLE and 2.21 (95% CI 2.03–2.41) for SLE. CLE and SLE were associated with a significantly increased risk of CVD and all-cause mortality. Local and chronic inflammation may be the driver of low-grade systemic inflammation.

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Long-Term Risk of Autoimmune Diseases other than Systemic Lupus Erythematosus in Cutaneous Lupus Erythematosus-Alone Patients: A 10-Year Nationwide Cohort Study

Dermatology ◽

10.1159/000515524 ◽

2021 ◽

pp. 1-9

Author(s):

Teng-Li Lin ◽

Chun-Ying Wu ◽

Chao-Kuei Juan ◽

Yun-Ting Chang ◽

Yi-Ju Chen

Keyword(s):

Systemic Lupus Erythematosus ◽

Cohort Study ◽

Autoimmune Diseases ◽

Lupus Erythematosus ◽

Cutaneous Lupus Erythematosus ◽

Research Database ◽

Systemic Lupus ◽

Systemic Corticosteroids ◽

Cutaneous Lupus

Background: Up to 25% of patients with cutaneous lupus erythematosus (CLE) can develop systemic lupus erythematosus (SLE). However, the risk of autoimmune diseases other than SLE in CLE patients who have only skin manifestations (CLE-alone) has rarely been explored. Objective: To investigate the long-term risk and independent factors of non-SLE autoimmune diseases among CLE-alone patients. Method: A nationwide cohort study using the Taiwanese National Health Insurance Research Database 1997–2013. CLE patients and matched subjects were included. Cumulative incidences of autoimmune diseases after 1 year of CLE-alone diagnosis were compared. Cox proportional hazard model was also performed. Results: A total of 971 CLE-alone patients and 5,175 reference subjects were identified. The 10-year cumulative incidence of autoimmune diseases other than SLE was significantly elevated in the CLE-alone cohort (9.00%, 95% confidence interval [CI] 6.72–11.29) than in the reference cohort (4.20%, 95% CI 3.53–4.87%) (p < 0.001). CLE-alone was independently associated with non-SLE autoimmune diseases (adjusted hazard ratio 1.55, 95% CI 1.10–2.18). Among CLE-alone patients, females and those taking long-term systemic corticosteroids (a proxy for extensive disease) were associated with non-SLE autoimmune diseases after adjusting for the number of repeated autoimmune laboratory tests. Conclusion: CLE-alone is independently associated with future non-SLE autoimmune diseases.

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Faculty Opinions recommendation of Cutaneous lupus erythematosus and the association with systemic lupus erythematosus: a population-based cohort of 1088 patients in Sweden.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.724197371.793557800 ◽

2019 ◽

Author(s):

Victoria Werth

Keyword(s):

Systemic Lupus Erythematosus ◽

Lupus Erythematosus ◽

Cutaneous Lupus Erythematosus ◽

Population Based ◽

Systemic Lupus ◽

Cutaneous Lupus

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Epidemiology of cutaneous lupus erythematosus and the associated risk of systemic lupus erythematosus: a nationwide cohort study in Denmark

Lupus ◽

10.1177/0961203318777103 ◽

2018 ◽

Vol 27 (9) ◽

pp. 1424-1430 ◽

Cited By ~ 14

Author(s):

M Prütz Petersen ◽

S Möller ◽

A Bygum ◽

A Voss ◽

M Bliddal

Keyword(s):

Systemic Lupus Erythematosus ◽

Cohort Study ◽

Lupus Erythematosus ◽

Time Course ◽

Cutaneous Lupus Erythematosus ◽

International Classification Of Diseases ◽

Systemic Lupus ◽

Classification Of Diseases ◽

National Patient ◽

Cutaneous Lupus

Objectives The objectives of this paper are to describe the epidemiology of cutaneous lupus erythematosus (CLE) and its subtypes in Denmark, and to investigate the probability of receiving a subsequent diagnosis of systemic lupus erythematosus (SLE) and the related time course. Methods A nationwide registry-based cohort study was conducted in Denmark based on data from the Danish National Patient Registry from 1998 to 2013 using International Classification of Diseases, Revision 10. Results We identified 2380 patients with CLE. The annual incidence rate (IR) of CLE was 2.74/100,000 with a female:male ratio of 4:1. During 12,047 person-years of follow-up, 8% were diagnosed with SLE. The probability of receiving a subsequent diagnosis of SLE was 12.9% after 10 years taking death as a competing risk into consideration, and the probability was highest among women and patients diagnosed with subacute CLE. The median time until a diagnosis of SLE was 2.05 years. Conclusions This is the first nationwide study on CLE in Denmark. Although we found the annual IR of CLE and the risk of receiving an additional diagnosis of SLE to be lower than previously described, continued monitoring and thorough information for patients with CLE is important due to the inherent risk of SLE.

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