Systemic lupus erythematosus is a risk factor for having multiple subtypes of cutaneous lupus erythematosus

Background: Patients with cutaneous lupus erythematosus (CLE) can present with one or multiple different subtypes of CLE. There is limited understanding of the prevalence and associated risk factors for having multiple CLE subtype diagnoses.

Objective: This study characterized the frequency and risk factors for having multiple CLE subtypes.

Methods: This was a cross-sectional study of 319 patients with CLE enrolled in the University of Texas Southwestern Cutaneous Lupus Registry seen in outpatient dermatology clinics at the University of Texas Southwestern Medical Center and Parkland Health from January 1, 2009 to December 31, 2021. Demographic and clinical information was collected from each subject and compared using univariate and multivariable logistic regression analyses.

Results: 59 subjects (18.5%) were diagnosed with two or more CLE subtypes. Univariate analyses identified statistically significant differences in rates of systemic lupus erythematosus (SLE) diagnosis, history of positive anti-nuclear antibody, arthritis, renal disorder, and serositis in patients with multiple CLE subtype diagnoses. In the multivariable analysis, SLE diagnosis was found to be statistically significant.

Conclusions: Our study showed that almost one out of five CLE patients have multiple CLE subtypes, with SLE diagnosis being a significant risk factor. Clinicians can monitor CLE patients for developing multiple subtypes and account for systemic manifestations and laboratory abnormalities associated with SLE.