The Impact of Cutaneous Lupus Erythematosus on Major Life-Changing Decisions: A Cross-Sectional Study

Cutaneous lupus erythematosus (CLE) is a chronic inflammatory skin disease that may influence patients' quality of life. While previous studies have addressed the psychosocial burden of CLE, its long-term effect on major life-changing decisions (MLCDs) has not been adequately investigated. A cross-sectional study of patients with CLE was performed, irrespective of disease subtype or severity, attending a tertiary dermatology center. Patients completed a structured questionnaire evaluating the impact of CLE on MLCDs using Likert-type scales. Sociodemographic, clinical, and psychometric data were also collected. Associations between clinical and sociodemographic features and MLCDs impairment were analyzed. Sixty-three patients were included (87.3% women; mean age 53.4 years). The most affected MLCDs domains were daily habits, followed by clothing choices, job performance, and social relationships. Patients with scalp or facial lesions reported greater limitations in lifestyle and dress, while those with SLE showed a significantly higher burden in work-related MLCDs and depressive symptoms (p < 0.05). Scarring, facial involvement, and systemic lupus erythematosus (SLE) were significantly associated with a greater negative impact (p < 0.05). CLE significantly alters the long-term decision-making of affected patients. Clinical predictors such as scarring, facial involvement, and systemic involvement should prompt early intervention. These findings raise the hypothesis of a potential "therapeutic window of opportunity" in CLE, where earlier and more intensive treatment could help reduce the risk of irreversible damage and mitigate the cumulative life impact of the disease. Future longitudinal studies are essential to confirm these associations and to determine how MLCD-focused outcomes can be incorporated into clinical practice and patient-centered strategies.