Cigarette smoking and cutaneous damage in systemic lupus erythematosus.
OBJECTIVE
To evaluate the association between cigarette smoking and cutaneous damage in systemic lupus erythematosus (SLE).


METHODS
Our study was performed in SLE clinic registry cohort patients, all of whom fulfilled revised American College of Rheumatology criteria for SLE; patients are followed prospectively with annual assessments that include collection of demographic variables, smoking history, disease activity (SLE Disease Activity Index version 2000, SLEDAI-2K), medications, and damage scores (Systemic Lupus International Collaborating Clinics/ACR Damage Index). Cumulative cutaneous damage scores were used for the primary analyses. Logistic and logit regression models were performed to examine potential associations between current smoking and cutaneous damage, controlling for age, sex, race, lupus disease duration, antimalarial or immunosuppressant use, and anti-DNA and anti-SSA antibody status.


RESULTS
Of our sample (N = 276), 92% were women and 73.7% were Caucasian; the mean age was 45.1 years, mean disease duration 13.5 years, and 17.5% were current smokers. In the regression analyses, current cigarette smoking was associated with total cutaneous damage (OR 2.73, 95% CI 1.10, 6.81) and with scarring (OR 4.70, 95 CI 1.04, 21.2). In additional analyses, current smoking was also associated with active lupus rash (OR 6.18, 95% CI 1.63, 23.3).


CONCLUSIONS
Current cigarette smoking may be associated with cutaneous damage and active lupus rash in SLE, suggesting another reason to emphasize smoking cessation in patients with SLE.
Turchin
Irina
I
Division of General Internal Medicine, Department of Medicine, McGill University Health Centre, Montreal, Quebec, Canada.
Bernatsky
Sasha
S
Clarke
Ann E
AE
St-Pierre
Yvan
Y
Pineau
Christian A
CA
D018450:Disease Progression; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000473:pathology* / Q000503:physiopathology; D008875:Middle Aged; D011446:Prospective Studies; D012044:Regression Analysis; D012307:Risk Factors; D012720:Severity of Illness Index; D012871:Skin Diseases / Q000209:etiology / Q000473:pathology; D012907:Smoking / Q000009:adverse effects*