Dyspigmentation and scarring in cutaneous lupus erythematosus

No studies have investigated the incidence and correlation of scarring and dyspigmentation across all cutaneous lupus erythematosus (CLE) categories and subtypes. As better characterisation of such symptoms may impact how clinicians document disease damage as well as manage patients' expectations on their disease course, we set out to investigate the relationship between dyspigmentation and scarring in CLE further.

We conducted a cross-sectional review of our IRB-approved CLE database at the University of Pennsylvania. Patients were divided by category and chronic CLE (CCLE) subtype. Dyspigmentation and scarring were quantified using the CLE Disease Area and Severity Index damage score. Data on dyspigmentation and scarring were captured from the patient visit where dyspigmentation was highest.

Dyspigmentation and scarring significantly differed between CLE categories and CCLE subtypes. Across categories, CCLE had the highest medians for dyspigmentation and scarring. Across CCLE subtypes, discoid lupus erythematosus (DLE) had the highest medians for dyspigmentation and scarring. Positive correlations for dyspigmentation and scarring were seen in CCLE, DLE and LE panniculitis.

Dyspigmentation and scarring correlation differences highlight the importance of accurate assessment and documentation of both elements of damage as well as classification of CLE category and subtype. Our results reflect important differences in the CLE categories and CCLE subtypes which may be helpful for clinicians and patients as they navigate the course of the disease.