title: Photoprovocation in cutaneous lupus erythematosus: a multicenter study evaluating a standardized protocol.
abstract: Photosensitivity is an important and distinguishing sign in various subtypes of cutaneous lupus erythematosus (CLE); however, it remains poorly defined. The purpose of this study was to evaluate whether standardized photoprovocation is a reproducible method to assess photosensitivity in subjects with CLE. A total of 47 subjects with CLE (subacute cutaneous lupus erythematosus (SCLE), n=14; discoid lupus erythematosus (DLE), n=20; lupus erythematosus tumidus (LET), n=13) and 13 healthy volunteers underwent photoprovocation at seven European sites. Of these, 22 (47%) subjects (57% SCLE, 35% DLE, and 54% LET) and none of the healthy volunteers developed photoprovoked lesions according to clinical analysis. Of these 22 subjects, 19 (86%) developed lesions that were histopathologically confirmed as specific for lupus erythematosus (LE). In CLE subjects who developed UV-induced lesions, 86% had Fitzpatrick's phototypes I or II, and the mean minimal erythema dose (MED) was significantly lower compared with subjects without UV-induced lesions (P=0.004). No significant differences in photoprovocation results were observed between study sites. Safety parameters showed no clinically meaningful differences between CLE subjects and healthy volunteers after photoprovocation. In conclusion, a standardized, safe, and reproducible protocol for photoprovocation using UVA and UVB radiation induced skin lesions in approximately half of all CLE subjects and showed comparable results across multiple sites. This method may therefore be used for future diagnostic testing and clinical trials.
authors: Department of Dermatology, University of Münster, Münster, Germany. kuhnan@uni-muenster.de
authors: Annegret
authors: A
authors: Kuhn
authors: Anna
authors: A
authors: Wozniacka
authors: Jacek C
authors: JC
authors: Szepietowski
authors: Regine
authors: R
authors: Gläser
authors: Percy
authors: P
authors: Lehmann
authors: Merle
authors: M
authors: Haust
authors: Anna
authors: A
authors: Sysa-Jedrzejowska
authors: Adam
authors: A
authors: Reich
authors: Vilija
authors: V
authors: Oke
authors: Rainer
authors: R
authors: Hügel
authors: Cesar
authors: C
authors: Calderon
authors: Dick E
authors: DE
authors: de Vries
authors: Filippa
authors: F
authors: Nyberg