Correlation Between Skin Lesions And Other Clinical Manifestations In Patients With SLE

Objective(s):To retrospectively study the relation of skin lesions with other clinical manifestations,Complications or organ damages,and to explore the correlation between them.To provide reference value and clue for diagnosis,treatment and prognosis of systemic lupus erythematosus.Methods:1000 SLE patients diagnosed and admitted by Dermatology and Rheumatology departments of the second affiliated hospital of kunming medical university from 1999 to 2019,were enrolled in this study.All cases were divided into positive group and negative group according to the existence of skin lesions.Perform statistical analysis on laboratory indicators and other clinical manifestations.The measurement data that conform to or approximate to a normal distribution are expressed as a mean± standard deviation(χ±S),the data comparison between groups was performed by independent sample t test.Non-normally distributed measurement data are expressed in interquartile range as Md(P25,P75),the data comparison between groups was performed by Mann-Whitney U test.The count data and rank data between groups was performed by Chi-square test,he data comparison within the group was performed by Bonferroni test.To use Logistic regression analysis to analyze the correlation between skin lesions and other clinical manifestations.with P<0.05 for the difference was statistically significant.Results:Of the 1000 SLE patients,109 were males and 891 were females,with a ratio of 1:8.17.The average age of the patients was 37.53±14.26 years old.There was no significant difference in the age of onset between male and female patients.In this study,the blood system(82.3%)was the most frequently involved organ in SLE patients,followed by skin(81.5%),joint(64.9%),kidney(58.2%),liver(56.9%),vasculitis(44.4%),Serositis(39%),Interstitial pneumonia(33.8%),nervous system damage(19.1%),pulmonary hypertension(12.6%),splenomegaly(11.3%),gastroenteritis(5.9%).The lesion with the highest incidence is malar rash(60.6%),followed by Vasculitis(44.4%),lupus alopecia(26.6%),photosensitivity(16.9%),oral ulcers(16.8%),lymphadenopathy(14.7%).Logistic regression analysis shows arthritis(P<0.001,OR 2.039,95%CI 1.458～2.852),photosensitivity(P<0.001,OR 4.231,95%CI 2.554～7.007),fingertip erythema(P=0.002,OR 2.270,95%CI 1.347～3.826),epilepsy(P=0.014,OR 2.844,95%CI 1.240～6.522),and interstitial pneumonia(P<0.001,OR 1.980,95%CI 1.397～2.807)are risk factors for malar rash.High-density lipoprotein(P=0.006,OR 0.420,95%CI 0.227～0.775),serum CO2 OP=0.039,OR 0.910,95%CI 0.834～0.993),and nephritis(P=0.030,OR 0.514,95%CI 0.282～0.937)are protective factors for discoid erythema.Anticardiolipin antibodies(P=0.039,OR 1.791,95%CI 1.031～3.113)and photosensitivity(P=0.001,OR 2.364,95%CI 1.447～3.863)are risk factors for discoid erythema.Anticardiolipin antibody IgM(P=0.038,OR 0.484,95%CI 0.244～0.959)is a protective factor for Localized ACLE.Arthritis(P<0.001,OR 2.606,95%CI 1.731～3.922),fingertip erythema(P=0.001 OR 2.627,95%CI 1.458～4.730),interstitial pneumonia(P=0.015,OR 1.628,95%CI 1.101～2.406)are risk factors for Localized ACLE.Serum chlorine(P=0.021,OR 0.944,95%CI 0.898～0.991)and pericardial effusion(P=0.034,OR 0.517,95%CI 0.282～0.951)are the protective factors of generalized ACLE.Creatinine(P=0.003,OR 1.004,95%CI 1.001～1.006),photosensitivity(P<0.001,OR 2.627,95%CI 1.655～4.170),epilepsy(P=0.039,OR 2.468,95%CI 1.048～5.811),and liver injury(P=0.003,OR 1.969,95%CI 1.260～3.076)are risk factors of generalized ACLE.Anti-nuclear antibodies(P=0.003,OR 0.674,95%CI 0.522～0.871)are the protective factors of CCLE.Anti-ribosomal P protein antibodies(P=0.012,OR 1.315,95%CI 1.062～1.627),anti-cardiolipin antibodies IgG(P=0.010,OR 4.072,95%CI 1.391～11.923),and lupus alopecia(P=0.024,OR 1.784,95%CI 1.080～2.948)are risk factors of CCLE.Complement C3(P=0.002,OR 0.329,95%CI 0.162～0.669)is a protective factor for lupus alopecia.Mental symptoms(P=0.009,OR 1.378,95%CI 1.084～1.750)are a protective factor for photosensitivity.Anti-Sm antibodies(P=0.009,OR 1.378,95%CI 1.084～1.750)and arthritis(P=0.027,OR 1.746,95%CI 1.066～2.860)are risk factors for oral ulcer.Mental symptoms(P=0.008,OR 0.244,95%CI 0.085～0.697)is a protective factor for photosensitivity.Anti-Sm antibodies(P=0.012,OR 1.313,95%CI 1.061～1.624)and Sjogren’s syndrome(P=0.001,OR 2.603,95%CI 1.461～4.636)are risk factors for photosensitivity.Anti-Sm antibodies(P=0.013,OR 1.273,95%CI 1.052～1.541)and arthritis(P=0.013,OR 1.530,95%CI 1.095～2.139)are risk factors for vasculitis.Serum Globulin(P=0.024,OR 1.039,95%CI 1.005～1.073),anti-RNP antibodies(P=0.001,OR 1.518,95%CI 1.194～1.929),anti-cANCA antibodies(P=0.006,OR 6.590,95%CI 1.725～25.180),arthritis(P=0.018,OR 2.130,95%CI 1.140～3.977),and pericardial effusion(P=0.018,OR 2.531,95%CI 1.176～5.445)are risk factors for Raynaud’s phenomenon.Conclusion(s):There is gender bias in the incidence of SLE.The disease is more likely to occur in women,but there is no significant difference in the age of onset between men and women.The most common systemic damages of SLE are blood system,skin and joint.The skin lesions are related to other clinical features,they may be used to predict the occurrence,development and the prognosis of SLE.