Responsiveness of the CLASI to Alopecia and Mucous Membrane Involvement: A Retrospective Study of Prospectively Collected Data

This study evaluated the impact of excluding alopecia and mucous membrane components from the Cutaneous Lupus Disease Activity and Severity Index (CLASI) in 171 patients with cutaneous lupus erythematosus (CLE). The results showed that removing these components led to a median difference in CLASI-A percent change of -1.39% for patients with recent hair loss or mucous membrane lesions, -2.08% for those with diffuse hair loss, and -11.76% for those with focal/patchy alopecia. The most significant change was observed in patients with focal/patchy alopecia. The study concluded that excluding these components limits the ability to capture important clinical information on disease activity, suggesting that they should be retained in the CLASI-A score due to their significant impact on patients' quality of life and the extensive validation of the CLASI.