Photo Credit: SaevichMikalai

The following is a summary of “Characterization of Clinicopathological Features and Autoantibody Profiles in Patients with Cutaneous Lupus Erythematous: A Single-Center Retrospective Study,” published in the January 2025 issue of Dermatology by Pazhyanur et al. 

Cutaneous lupus erythematosus (CLE) is an autoimmune condition with diverse clinical presentations and limited treatment options, and the prognostic significance of commonly used diagnostic tests, such as antinuclear antibodies (ANA) and extractable nuclear antigens (ENA), in CLE, remains largely unexplored.  

Researchers conducted a retrospective study to characterize the clinicopathological features, patient demographics, and treatment responses in individuals with CLE.  

They included patients diagnosed with CLE using International Classification of Diseases, Ninth Revision (ICD-9) and ICD-10 codes who were seen at Michigan Medicine’s Department of Dermatology from January 1, 2012, to December 31, 2022. A chart review was conducted to gather data on CLE subtype, demographics, disease course, presence of SLE, ANA, ENA results, and treatments and responses.  

The results showed 390 patients with CLE of 86% (n = 334) having biopsy-proven CLE. Most were female (77%), non-Hispanic (97%), and Caucasian (58%), of all patients, 35% (n = 138) were ANA negative. Common treatments included antimalarials (86%, n = 336), topical steroids (85%, n = 331), systemic steroids (42%, n = 164), and mycophenolate mofetil (30%, n = 119). Treatment response ranged from disease stabilization to complete remission. The highest response rates were with systemic steroids (84%, n = 138), antimalarials (63%, n = 212), belimumab (54%, n = 29), and topical steroids (50%, n = 165). Lower response rates to antimalarials were associated with anti-double stranded (ds) DNA (57% vs 74%), anti-Smith (54% vs 72%), anti-RNP (56% vs 73%), anti-SmRNP (54% vs 74%), anti-chromatin (50% vs 74%), SLE (57% vs 79%), and acute CLE subtype (58% vs 71%). Logistic regression showed that anti-dsDNA (OR 0.5), anti-Smith (OR 0.5), and anti-chromatin (OR 0.6) were associated with lower response rates to antimalarials.  

Investigators concluded the presence of ACLE, SLE, and specific autoantibodies (anti-dsDNA and anti-Smith) might be associated with lower treatment response rates to commonly used therapies for CLE, such as topical steroids and antimalarials. 

Source: link.springer.com/article/10.1007/s40257-024-00916-6