The Burden of Living With Cutaneous Lupus Erythematosus

Abstract

Cutaneous lupus erythematosus (CLE) is a group of heterogeneous autoimmune disorders primarily affecting the skin. Patients with these conditions are mostly young women when they become sick and often suffer from recurrent skin symptoms or longstanding changes in their physical appearance. CLE disorders lead to different levels of morbidity and can impact profoundly patients' quality of life, particularly in the psychological and social health domains. This review provides a summary of recent research investigating the psychosocial burden of living with CLE and the intersect amongst the disease characteristics, patient factors, and social determinants of health. Furthermore, this review provides insight into patient care and research needs that remain unmet to improve the quality of life of patients living with CLE.

Classification of psychodermatological disorders: Proposal of a new international classification

“…[63][64][65][66] In lymphocytic primary cicatricial alopecias, including chronic cutaneous lupus erythematosus, lichen planopilaris and frontal fibrosing alopecia, a pathophysiological link with stress could be possible, but studies are required on these dermatoses. 67,68 In the subgroup 'functional skin disorders', psychological stress can also contribute to the pathophysiology of the disorders, within a multifactorial etiopathogenesis. Additionally, patients with chronic pruritus may present with important psychological characteristics and psychiatric comorbid disorders (namely anxiety and depression) that modulate the experience of pruritus, with relevance in the management.…”

“…These primary dermatoses are also associated with secondary psychiatric comorbidities which is a relevant aspect in other primary dermatoses that do not seem to present a pathophysiological link with stress, such as some examples of autoimmune bullous dermatoses (dermatitis herpetiformis, IgA bullous dermatosis), androgenetic alopecia, hidradenitis suppurativa, lichen sclerosus, toxic epidermal necrolysis, Stevens–Johnson syndrome, genodermatoses and cicatricial alopecias, particularly, primary neutrophilic cicatricial alopecias, such as folliculitis decalvans and dissecting cellulitis of the scalp 63–66 . In lymphocytic primary cicatricial alopecias, including chronic cutaneous lupus erythematosus, lichen planopilaris and frontal fibrosing alopecia, a pathophysiological link with stress could be possible, but studies are required on these dermatoses 67,68 …”

Cutaneous lupus erythematosus is associated with an increased risk of cardiac and vascular diseases: a large-scale, propensity-matched global retrospective cohort study

“…Chronic inflammatory diseases, such as CLE, impose a high medical burden. 6 , 25 Particularly, cardiovascular risks in several chronic autoimmune diseases such as psoriasis, inflammatory bowel diseases and rheumatoid arthritis, are well-documented, 26 and pathophysiological mechanisms were shown. 13 By contrast, little evidence is available regarding a potential etiologic link between thromboembolism and CLE.…”

“…Both are triggered by ultraviolet radiation and SCLE can be drug-induced. 4 The quality-of-life burden in CLE is often severe 5 , 6 and the risk of depression is increased. 7 CLE has a multitude of potential sequelae including, e.g., transition into systemic lupus erythematosus (SLE) found in 10–20%, 2 , 8 , 9 , 10 and an increased risk of cancer.…”