Discoid Lupus Erythematosus Skin Lesion Distribution and Characteristics in Black Patients: A Retrospective Cohort Study

November 2021 in “ Lupus Science & Medicine ”

Adrienne Joseph, Brandon Windsor, Linda S. Hynan, Benjamin F. Chong

discoid lupus erythematosus DLE CLASI damage scores dyspigmentation scalp involvement ear involvement scalp dyspigmentation ear dyspigmentation scarring alopecia discoid lupus skin lesion scalp discoloration ear discoloration hair loss

TLDR Black patients with discoid lupus erythematosus have more severe skin damage and higher chances of dyspigmentation, scalp, and ear involvement.

This retrospective cohort study examined 183 patients with discoid lupus erythematosus (DLE), including 112 Black and 71 non-Black individuals, to identify differences in lesion distribution and characteristics. Black patients had significantly worse baseline CLASI damage scores (median: 10.0 vs 6.0, p<0.001) and higher odds of dyspigmentation (48.9 times greater, p<0.001), scalp involvement (2.54 times greater, p=0.015), and ear involvement (1.97 times greater, p=0.032). They also had higher odds of scalp dyspigmentation (OR=5.85, p<0.001), ear dyspigmentation (OR=2.89, p=0.001), and scarring alopecia (OR=3.00, p=0.001). Recognizing these differences can help in understanding the factors influencing DLE presentation and outcomes in Black patients and guide clinical counseling.

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