Prevalence of Pruritus in Cutaneous Lupus Erythematosus: Brief Report of a Multicenter, Multinational Cross-Sectional Study.

Dominik Samotij ,Zygmunt Adamski ,Aleksandra Lesiak ,Minoru Hasegawa ,Adriana Polańska ,Takaharu Ikeda ,Mohammad Rafiqul Mowla ,Fukumi Furukawa ,Emiliano Antiga ,Aleksandra Dańczak‐Pazdrowska ,Justyna Szczęch ,Laurent Miséry ,Carolyn J Kushner ,François Chasset ,Daisuke Tsuruta ,A.b.m Alim Al Islam ,Hideo Hashizume ,Victoria P Werth ,Jacek C Szepietowski ,Adam Reich

doi:10.1155/2018/3491798

Abstract

Pruritus is an important symptom frequently accompanying various inflammatory skin conditions. Some recent data have indicated that it may also be associated with autoimmune connective tissue diseases, including systemic sclerosis and dermatomyositis; however, studies on the prevalence and clinical characteristics of pruritus in CLE are limited. We have performed a multinational, prospective, cross-sectional study in order to assess the prevalence and intensity of pruritus in adult patients suffering from various subtypes of CLE. After developing a questionnaire assessing various aspects of pruritus, we have surveyed 567 patients with cutaneous involvement during the course of LE regarding the presence and intensity of pruritus. Pruritus was present in 425 of all patients (75.0%) and was most frequently reported by subjects with acute CLE (82.1%), followed by chronic CLE (78.8%), subacute CLE (65.9%), and intermittent CLE (55.6%) (p<0.001). Based on the Numerical Rating Scale, the severity of itch was mild, moderate, and severe in 264 (62.1%), 98 (23.1%), and 63 (14.8%) patients, respectively. The highest mean pruritus intensity was reported by subjects with hypertrophic LE (5.1 ± 3.0 points) followed by generalized discoid LE (3.6 ± 3.0 points), subacute CLE (3.0 ± 3.0 points), chilblain LE (3.0 ± 1.0 points), localized discoid LE (2.6 ± 2.0 points), intermittent CLE (2.6 ± 3.0 points), acute CLE (2.5 ± 1.2 points), and lupus erythematosus profundus (1.9 ± 2.7 points). In conclusion, pruritus is a frequent phenomenon in CLE; however, in most patients it is of mild severity. Further studies are needed to better characterize its clinical characteristics and influence on patients' well-being.

Highlights

Cutaneous lupus erythematosus (CLE) is an autoimmune condition encompassing a wide range of dermatologic manifestations
LE-specific skin lesions are divided into several subtypes based on clinical characteristics: acute CLE (ACLE), subacute CLE (SCLE), and chronic CLE (CCLE) with several variants including discoid LE (DLE), presenting as a localized or generalized form, LE profundus (LEP), hypertrophic LE (HLE), chilblain LE (CHLE), and lupus erythematosus tumidus (LET) [1]
Pruritus was present in 425 of all analyzed patients (75.0%). It was most frequently reported by subjects with ACLE (82.1%), followed by CCLE (78.8%), SCLE (65.9%), and intermittent CLE (ICLE) (55.6%) (p

Summary

Introduction

Cutaneous lupus erythematosus (CLE) is an autoimmune condition encompassing a wide range of dermatologic manifestations. LE-specific skin lesions are divided into several subtypes based on clinical characteristics: acute CLE (ACLE), subacute CLE (SCLE), and chronic CLE (CCLE) with several variants including discoid LE (DLE), presenting as a localized or generalized form, LE profundus (LEP) ( called lupus panniculitis or subcutaneous LE), hypertrophic LE (HLE), chilblain LE (CHLE), and lupus erythematosus tumidus (LET) [1]. Discrepancies between various studies that included itch evaluation in LE patients with cutaneous involvement may suggest that, without adequate investigation by medical personnel, the presence of this bothersome symptom could be underestimated or even missed. We performed a multinational, multicenter study to precisely assess the prevalence and clinical characteristics of pruritus in different variants of CLE in relation to skin lesion spectrum

Methods

Results

Conclusion