840 Unsupervised learning reveals different degrees of heterogeneity as well as cell involvement in cutaneous lupus erythematous antimalarial treatment response subgroups

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First-line treatment for cutaneous lupus erythematosus involves the use of antimalarials. Treatment response is highly variable with some patients responding well to hydroxychloroquine (HCQ), some necessitating the addition of quinacrine (QC) and others refractory to treatment from both (NR). Here we used unsupervised learning to highlight differences between the immune infiltrate composition of the three treatment groups. Infiltrate composition was characterized using imaging mass cytometry, where we stained biopsies (12 HCQ, 11 QC, 20 NR) with two separate panels of 37-metal conjugated antibodies, which enabled the measurement of different cell types, cytokines and pathway proteins within the tissue sample.