title: Evaluation of disease activity and damage in different subtypes of cutaneous lupus erythematosus using the CLASI.
abstract: BACKGROUND
  The Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI) is a scoring system for patients with cutaneous lupus erythematosus (CLE) to assess disease activity and damage. Objective  The aim of this study was to evaluate whether the CLASI is a useful instrument which reflects the different subtypes of CLE comparably well in each parameter.
  
  
  METHODS
  A total of 50 patients (42 female, 8 male) with different subtypes of CLE, including acute CLE (ACLE), subacute CLE (SCLE), chronic CLE (CCLE) and LE tumidus (LET), from the Departments of Dermatology, University of Düsseldorf, Germany, and Danderyd Hospital, Stockholm, Sweden, were evaluated using the CLASI at one time point.
  
  
  RESULTS
  The total CLASI activity score was significantly lower in patients with LET compared with ACLE (P<0.05) and CCLE (P<0.001), and the total CLASI damage score was significantly lower in patients with LET than with ACLE (P<0.05), SCLE (P<0.001) and CCLE (P<0.001). The erythema score and the scale/hypertrophy score were significantly lower in LET than in ACLE (P<0.05, both) and CCLE (P<0.05 and P < 0.001, respectively). The dyspigmentation score was lowest in patients with LET, differing significantly from ACLE (P<0.05), SCLE (P<0.05) and CCLE (P<0.001). The scarring/atrophy/panniculitis score was significantly higher in patients with CCLE in contrast to SCLE and LET (P<0.05 and P<0.001, respectively).
  
  
  CONCLUSIONS
  These data characterize the CLASI as an overall useful instrument to analyse disease activity and damage in CLE. However, the CLASI does not give an accurate assessment of all disease subtypes; therefore, a revision of the CLASI with critical analysis of all parameters is recommended.
authors.affiliation: Department of Dermatology, University of Münster, Münster, Germany.
authors.forename: D
authors.initials: D
authors.lastname: Bein
authors.forename: E
authors.initials: E
authors.lastname: Kuehn
authors.forename: A M
authors.initials: AM
authors.lastname: Meuth
authors.forename: S
authors.initials: S
authors.lastname: Amler
authors.forename: M
authors.initials: M
authors.lastname: Haust
authors.forename: F
authors.initials: F
authors.lastname: Nyberg
authors.forename: C
authors.initials: C
authors.lastname: Sauerland
authors.forename: T A
authors.initials: TA
authors.lastname: Luger
authors.forename: G
authors.initials: G
authors.lastname: Bonsmann
authors.forename: A
authors.initials: A
authors.lastname: Kuhn
mesh_terms: D000328:Adult; D000368:Aged; D000505:Alopecia / Q000209:etiology / Q000473:pathology; D000974:Antibodies, Antinuclear / Q000097:blood; D001284:Atrophy / Q000209:etiology / Q000473:pathology; D002921:Cicatrix / Q000209:etiology / Q000473:pathology; D004890:Erythema / Q000209:etiology / Q000473:pathology; D005260:Female; D006801:Humans; D006984:Hypertrophy / Q000209:etiology / Q000473:pathology; D008178:Lupus Erythematosus, Cutaneous / Q000150:complications / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015434:Panniculitis / Q000209:etiology / Q000473:pathology; D010859:Pigmentation Disorders / Q000209:etiology / Q000473:pathology; D012720:Severity of Illness Index; D012867:Skin / Q000473:pathology*; D055815:Young Adult
chemical_list: D000974:Antibodies, Antinuclear