Evaluation of disease activity and damage in different subtypes of cutaneous lupus erythematosus using the CLASI

Bein, Dennis; Kuehn, Esther; Meuth, Anne; Amler, Susanne; Haust, Merle; Nyberg, Filippa; Sauerland, Cristina; Luger, Thomas A.; Bonsmann, Giesela; Kuhn, Annegret

doi:10.1111/j.1468-3083.2010.03844.x

Cited by 19 publications

(30 citation statements)

References 22 publications

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“…by Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI), which is a very detailed and accurate measurement of CLE severity, but is also time-consuming and thus seems to be not very feasible for regular use. This scoring system has been designed to measure CLE activity and skin damage [10][11][12]. Severity of such features like erythema, scaling, hypertrophy, edema and infiltration in different anatomical locations are summed up to assess disease activity.…”

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confidence: 99%

“…Severity of such features like erythema, scaling, hypertrophy, edema and infiltration in different anatomical locations are summed up to assess disease activity. Skin damage considers dyspigmentation, scarring, atrophy and panniculitis [10,11]. To standardize the assessment of CLE patients the European Society of Cutaneous Lupus Erythematosus developed the Core Set Questionnaire which includes six sections covering patient data, detailed diagnosis, skin involvement, CLASI, laboratory findings and treatment [13].…”

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Clinical characteristics of cutaneous lupus erythematosus

Szczęch

Rutka

Samotij

et al. 2016

pdia

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13 IntroductionLupus erythematosus (LE) is a chronic autoimmune disease with a wide spectrum of presenting symptoms ranging from mild cutaneous manifestations in localized cutaneous LE (CLE) to severe, life-threatening internal organ damage in systemic LE (SLE). The etiology of LE remains unknown, although the environmental, genetic, viral and hormonal factors are taken into consideration as probable causes or precipitating factors of this disease [1,2].Skin involvement is seen in about 70-85% of all LE patients [3]. Sometimes skin involvement is the only manifestation of LE, while in other cases it could rather be a mild bystander of severe internal involvement. Isolated CLE is a rare disease, albeit it is still about 2 to 3 times more frequent than SLE [4]. Cutaneous features of LE can be classified into LE-specific and LE-nonspecific ones. LEspecific skin lesions usually appear only in patients with LE and thus can be handled as diagnostic ones (e.g. "ma- Aim: To analyze the clinical presentation of cutaneous variants of lupus erythematosus in terms of skin lesion spectrum and extracutaneous involvement. Material and methods: A total of 64 patients with cutaneous LE (CLE) were included. The study was based on the "Core Set Questionnaire" developed by the European Society of Cutaneous Lupus Erythematosus (EUSCLE). Clinical severity of skin lesions was evaluated with the Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI). All results were subjected to statistical analysis. Results: Fifteen (23.4%) patients had an acute CLE (ACLE), 26 (40.6%) subacute CLE (SCLE) and 21 (32.8%) chronic CLE (CCLE). Two (3.2%) individuals only demonstrated urticarial vasculitis as a cutaneous manifestation of LE and these patients were excluded. Patients with ACLE were characterized by the earliest onset of the disease (mean age of 31.9 ±15.0 years; p < 0.001). On average, 4.8 ±1.8 criteria of systemic LE were found in the ACLE group compared to 2.7 ±1.3 criteria in SCLE and 2.5 ±1.5 criteria in CCLE (p < 0.001). The highest activity of skin lesions according to CLASI was found in the SCLE group (p = 0.002). On the other hand, the most severe skin damage was observed in CCLE (p < 0.01). Conclusions: Each variant of CLE differs significantly from the others in respect of various aspects of clinical manifestations. Due to a number of different variants of LE skin lesions, a unified classification of CLE still remains a challenge.

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Clinical characteristics of cutaneous lupus erythematosus

Szczęch

Rutka

Samotij

et al. 2016

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“…X-ray exposure, and exposure to arsenic, tar or polycyclic hydrocarbons. Skin cancer may also arise in scars after trauma (5). Individuals who bum easily and with blue eyes have an increased risk of development of both SCC and BCC (6,7).…”

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“…No adverse effects were observed. The severity of symptoms was evaluated according to the Cutaneous Disease Area and Severity Index (CLASI) scoring system (5). The CLASI analyses the activity of the disease on the basis of erythema and scaling, and damage from the disease due to dyspigmentation, scarring and alopecia (6).…”

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Ustekinumab in the Treatment of Refractory Chronic Cutaneous Lupus Erythematosus: A Case Report

Dahl¹,

Johansen²,

Kragballe³

et al. 2013

Acta Derm Venerol

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“…Bein ve ark. 'nın 21 yaptıkları çalışmada kırk yaş ve altı hastaların aktivite ve hasar skorunun, kırk yaş üstü hastalara göre daha düşük olduğu ancak istatistiksel olarak anlamlı bir fark olmadığı ortaya konmuştur. Bu bulgular da, aktivite ve hasar skorunun yaş ile ilişkili olmadığını düşündürmektedir.…”

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Evaluation of skin lesions of lupus with Turkish revised cutaneous lupus erythematosus disease area and severity index

Ürün¹,

Dönmez²,

Arıcan³

et al. 2014

TURKDERM

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Background and Design:The Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI) is used to evaluate the cutaneous manifestations in patients with lupus erythematosus (LE). In recent years, the Revised Cutaneous Lupus Erythematosus Disease Area and Severity Index (RCLASI) which provides more objective assessment has been developed, but the number of studies utilizing RCLASI are limited. The aim of this study was to increase the clinical use of the RCLASI by translating this scale into Turkish and to evaluate the effects of factors, which affect CLASI, on RCLASI. Materials and Methods: The scale was translated into Turkish by using proper international translation steps. Ninety-three LE patients who were admitted to Trakya University Faculty of Medicine were included in this study. Socio-demographic and clinical characteristics of the patients were recorded. Cutaneous manifestations were calculated using RCLASI. Two scores were obtained: activity and damage scores. The relationship of the scores with patient age, gender, duration of illness, facial involvement, subtypes of LE, and antinuclear antibody, Anti-Ro/ SS-A antibody and Anti-La/SS-B antibody positivities were evaluated. Results: The mean activity and damage scores were 2.59±2.88 and 0.81±1.88, respectively. When activity and damage scores were compared between the age groups, there was no statistically significant difference. The damage scores were significantly higher in male patients than in female patients. The activity scores were statistically significantly higher in patients with disease duration of more than three years and facial involvement. There was no statistically significant difference between the subtypes of LE and the activity and damage scores. RCLASI damage scores were statistically significantly higher in Anti-La/SS-B antibody positive patients.

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Evaluation of disease activity and damage in different subtypes of cutaneous lupus erythematosus using the CLASI

Abstract: These data characterize the CLASI as an overall useful instrument to analyse disease activity and damage in CLE. However, the CLASI does not give an accurate assessment of all disease subtypes; therefore, a revision of the CLASI with critical analysis of all parameters is recommended.

Cited by 19 publications

References 22 publications

Clinical characteristics of cutaneous lupus erythematosus

Clinical characteristics of cutaneous lupus erythematosus

Ustekinumab in the Treatment of Refractory Chronic Cutaneous Lupus Erythematosus: A Case Report

Evaluation of skin lesions of lupus with Turkish revised cutaneous lupus erythematosus disease area and severity index

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