ERYTHEMA AND SCALE INFLUENCE QUALITY OF LIFE AND IMPRESSION OF DISEASE PROGRESSION IN CUTANEOUS LUPUS PATIENTS

O017 / #393 Topic: AS07 - Cutaneous Lupus ABSTRACT CONCURRENT SESSION 02: SLE METRICS – IMPROVING OUTCOMES & MEASURES 22-05-2025 1:40 PM - 2:40 PM Background/Purpose The Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI) evaluates disease activity (CLASI-A) by assessing signs including erythema and scale in patients with cutaneous lupus erythematosus (CLE). While erythema and scale have been frequently mentioned as significant signs from patient interviews, their impact on how CLE patients feel about their skin disease has not been studied in larger patient cohorts. Understanding whether erythema and/or scale are important to patients would further justify their inclusion as scoring drivers in CLASI-A. Methods We conducted a prospective study investigating the relationships between CLASI-A erythema and scale scores and patient-reported outcome measures (PROMs) at baseline, and changes in these scores over 6 months. 131 CLE patients were recruited in outpatient dermatology clinics at University of Texas Southwestern Medical Center, Parkland Health, and University of Pennsylvania between July 2018 and November 2023. Examined PROMs included the CLE Quality of Life Index (CLEQoL), Dermatology Quality of Life Index (DLQI), Patient Impression of Disease Progression (PIDP), and Analogue Pain, Itch, and Fatigue Scales (APIFS). Spearman correlation analyses were performed to examine relationships between CLASI-A erythema or scale and PROMs. To compare the degree of association between CLASI-A erythema and scale vs PROMs, Spearman’s rho between erythema vs scale and PROMS were compared using paired t-test after Fisher’s transformation separately at baseline and then after 6 months. Results At baseline (N = 131), CLASI-A erythema had significant correlation to all PROMs, whereas scale directly correlated to all PROMs excluding the photosensitivity domain in CLEQoL (Table 1). Skin health from APIFS had the strongest correlation to erythema (r=-0.38, p<0.01) and scale (r=-0.32, p<0.01). After 6 months (N = 107), PIDP scores were most notably correlated to change in erythema (ρ = -0.41, p < 0.01) and scale (r = -0.23, p = 0.02) (Figure 1). The association between erythema and PROMs was not statistically different from that between scale and PROMs at baseline (p = 0.42) or after 6 months (p = 0.22). Table 1. Correlation Between CLASI-A Erythema and Scale vs. Patient-Reported Outcome Measures at Baseline Figure 1. Erythema and scale are correlated to PIDP scores after six months. Conclusions At baseline, erythema and scale had a significant correlation to nearly all PROMs, which validate the importance of both signs in affecting CLE patient lives. We also found that changes in erythema and scale were significantly correlated to PIDP after 6 months, suggesting that erythema and scale can contribute greatly to disease progression that matter to patients. These results affirm the substantial impact of erythema and scale in quality of life in CLE patients and demonstrate that improvement in erythema and scale can result in clinically meaningful benefit for CLE patients. They also justify the greater weighting of erythema in CLASI-A scoring, which can be responsive to treatments.

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