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A Retrospective Study of Skin Manifestations in Systemic Lupus Erythematosus and their association with Renal Involvement


Objective: To identify the types of skin disorders seen in systemic lupus erythematosus (SLE) and to establish the correlation, if any, between cutaneous manifestations, lupus erythematosus (LE) specificity and renal involvement.

Methods: The study was a retrospective, descriptive and analytical study conducted at the Dermatology Clinic at the University Hospital of the West Indies. Data were obtained from the medical records ofpatients diagnosed with SLE and referred to the Dermatology clinic over the period January 2002 to March 2015. Skin disorders were divided into LE-specific, LE-non-specific and those unrelated to lupus erythematosus based on the Gilliam classification.

Results: Thirty-eight patients with skin lesions fulfilled the criteria for SLE diagnosis. The female-to-male ratio was 18:1. Lesions of discoid lupus erythematosus (DLE) were the commonest skin disorder seen and constituted 50% (n = 19) of all lesions. The second most common skin disorders were the malar rash and non-scarring alopecia each of which occurred in 37% (n = 14). Fourteen of the 38 patients had renal disease (37%). Patients with LE-non-specific skin disease had 6.00 times the odds of developing renal disease (p = 0.044, 95% CI: 0.88, 46.41). There was no significant association between specific types of mucocutaneous disorders or the number of different types of skin lesions and renal disease. 

Conclusion: Lupus erythematosus-non-specific skin disease was associated with increased odds of having renal involvement in SLE. There appeared to be no difference in the prevalence of renal disease in patients with skin manifestations when compared to the overall prevalence in SLE found in other studies.

August 7, 2018
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