Association of Smoking With Cutaneous Manifestations in Systemic Lupus Erythematosus

Abstract

Objective. To examine the association between smoking and cutaneous involvement in systemic lupus erythematosus (SLE).Methods. We analyzed data from a multicenter Canadian SLE cohort. Mucocutaneous involvement was recorded at the most recent visit using the Systemic Lupus Erythematosus Disease Activity Index 2000 Update (rash, alopecia, and oral ulcers), Systemic Lupus International Collaborating Clinics/American College of Rheumatology (ACR) Damage Index (alopecia, extensive scarring, and skin ulceration), and the ACR revised criteria for SLE (malar rash, discoid rash, photosensitivity, and mucosal involvement). Multivariate logistic regression models were used to estimate the independent association between mucocutaneous involvement and cigarette smoking, age, sex, ethnicity, lupus duration, medications, and laboratory data. Results. In our cohort of 1,346 patients (91.0% women), the mean ؎ SD age was 47.1 ؎ 14.3 years and the mean ؎ SD disease duration was 13.2 ؎ 10.0 years. In total, 41.2% of patients were ever smokers, 14.0% current smokers, and 27.1% past smokers. Active mucocutaneous manifestations occurred in 28.4% of patients; cutaneous damage occurred in 15.4%. Regarding the ACR criteria, malar rash was noted in 59.5%, discoid rash in 16.9%, and photosensitivity in 55.7% of patients. In the multivariate analysis, current smoking was associated with active SLE rash (odds ratio [

Smoking is highly associated with discoid lupus erythematosus and lupus erythematosus tumidus: analysis of 405 patients

“…Smoking was not associated with these cutaneous manifestations in LE patients on logistic regression modelling. These data were consistent with those obtained by Bourre´-Tessier et al, 8 who found no clear correlation between smoking and malar rash and nasopharyngeal ulcerations. Accordingly, another study noted twice as many non-smokers with SLE than smokers in their study population.…”

“…In accordance with previous studies, 8,12 we also found that smokers were much more common among patients with CCLE than in the general population. However, in our population the difference was mainly due to patients with DLE.…”

Smoking and obesity in systemic lupus erythematosus: a cross‐sectional study

“…Several studies suggested that tobacco use may have a possible role in lupus. These studies highlighted an association between smoking and both forms of lupus: cutaneous lupus erythematosus [27][28][29] and SLE [3,10,[30][31][32][33]. In a recent retrospective study conducted on 405 cutaneous lupus erythematosus patients [16], Bockle and Sepp [34] reported a significantly higher percentage of smokers among cutaneous lupus erythematosus patients (45Á9%) compared to the general population (33Á2%, P < 0Á0001), with a higher prevalence of smokers in the population with tumidus and discoid lupus (P < 0Á0001).…”

Environmental Influences on Systemic Lupus Erythematosus Expression

“…35 Although cigarette smoke contains hundreds of potentially toxic components, is unclear whether its influence on SLE is attributable to an individual component or if the culprit is a mixture of tars, nicotine, carbon monoxide, polycyclic aromatic hydrocarbons, and/or others.…”