Abstract：
OBJECTIVE: To describe skin involvement (SI) in patients with systemic lupus erythematosus (SLE) at onset and during follow-up of the disease and to determine factors associated with SI at lupus diagnosis.
METHODS: Retrospective, observational, and descriptive study, from a single centre in patients diagnosed with SLE (ACR 1982-97 or SLICC 2012 criteria). The modified Gilliam classification for SI was used. Descriptive statistics and bivariate and multivariate analysis were performed to evaluate the factors associated with SI at diagnosis of the disease.
RESULTS: 149 patients were included, 91.3% women with a median age at diagnosis of 33 years. SI at onset of the disease occurred in 125 patients (83.9%), followed by joint involvement in 120 cases (80.5%). Non-specific skin lesions were more frequent than specific lesions, 92.8% versus 66.4%, respectively. In the bivariate analysis, a longer delay to diagnosis, the presence of joint involvement, a lower presence of thrombocytopenia, and a higher SLEDAI-2K score were associated with the presence of SI at onset of the disease. In the multivariate analysis, the variable that remained independently associated was joint involvement (OR 2.8%-95% CI 1.1-7.5, p: .04). During follow-up, 4/24 patients who had not presented SI at diagnosis and 51/125 patients who had, had at least one new skin flare (range: 1-5 outbreaks).
CONCLUSIONS: Our study demonstrates the high frequency of skin involvement in SLE, both diagnostically and evolutionarily, and confirms previously reported data regarding the existence of a skin-articular phenotype.
METHODS: Retrospective, observational, and descriptive study, from a single centre in patients diagnosed with SLE (ACR 1982-97 or SLICC 2012 criteria). The modified Gilliam classification for SI was used. Descriptive statistics and bivariate and multivariate analysis were performed to evaluate the factors associated with SI at diagnosis of the disease.
RESULTS: 149 patients were included, 91.3% women with a median age at diagnosis of 33 years. SI at onset of the disease occurred in 125 patients (83.9%), followed by joint involvement in 120 cases (80.5%). Non-specific skin lesions were more frequent than specific lesions, 92.8% versus 66.4%, respectively. In the bivariate analysis, a longer delay to diagnosis, the presence of joint involvement, a lower presence of thrombocytopenia, and a higher SLEDAI-2K score were associated with the presence of SI at onset of the disease. In the multivariate analysis, the variable that remained independently associated was joint involvement (OR 2.8%-95% CI 1.1-7.5, p: .04). During follow-up, 4/24 patients who had not presented SI at diagnosis and 51/125 patients who had, had at least one new skin flare (range: 1-5 outbreaks).
CONCLUSIONS: Our study demonstrates the high frequency of skin involvement in SLE, both diagnostically and evolutionarily, and confirms previously reported data regarding the existence of a skin-articular phenotype.
摘要：
目的：描述系统性红斑狼疮（SLE）患者在发病时和随访期间的皮肤受累（SI），并确定在狼疮诊断时与SI相关的因素。
方法：回顾性，观察,和描述性研究，来自诊断为SLE的患者的单个中心（ACR1982-97或SLICC2012标准）。使用改良的SIGilliam分类。进行描述性统计以及双变量和多变量分析以评估与SI诊断疾病相关的因素。
结果：包括149例患者，91.3%的女性在诊断时的中位年龄为33岁。疾病发作时的SI发生在125例患者中（83.9％），其次是关节受累120例(80.5%)。非特异性皮肤病变比特异性病变更常见，92.8%对66.4%，分别。在双变量分析中，诊断延迟更长，共同参与的存在，血小板减少症的发生率较低,和较高的SLEDAI-2K评分与疾病发作时SI的存在相关。在多变量分析中，独立相关的变量为关节受累(OR2.8%-95%CI1.1-7.5,p:.04).随访期间,4/24患者在诊断时没有出现SI，51/125患者有，至少有一个新的皮肤耀斑（范围：1-5次爆发）。
结论：我们的研究表明SLE皮肤受累的频率很高，诊断和进化，并确认了先前报道的有关皮肤关节表型存在的数据。
方法：回顾性，观察,和描述性研究，来自诊断为SLE的患者的单个中心（ACR1982-97或SLICC2012标准）。使用改良的SIGilliam分类。进行描述性统计以及双变量和多变量分析以评估与SI诊断疾病相关的因素。
结果：包括149例患者，91.3%的女性在诊断时的中位年龄为33岁。疾病发作时的SI发生在125例患者中（83.9％），其次是关节受累120例(80.5%)。非特异性皮肤病变比特异性病变更常见，92.8%对66.4%，分别。在双变量分析中，诊断延迟更长，共同参与的存在，血小板减少症的发生率较低,和较高的SLEDAI-2K评分与疾病发作时SI的存在相关。在多变量分析中，独立相关的变量为关节受累(OR2.8%-95%CI1.1-7.5,p:.04).随访期间,4/24患者在诊断时没有出现SI，51/125患者有，至少有一个新的皮肤耀斑（范围：1-5次爆发）。
结论：我们的研究表明SLE皮肤受累的频率很高，诊断和进化，并确认了先前报道的有关皮肤关节表型存在的数据。
