title: Pain and pruritus in cutaneous lupus: their association with dermatologic quality of life and disease activity.
abstract: OBJECTIVE
  To evaluate the association of pain and pruritus with Dermatologic Quality of Life (QoL) and cutaneous disease activity in patients with 1) specific cutaneous lupus erythematosus (CLE) lesions, 2) non-specific CLE lesions and 3) both types of CLE lesions.
  
  
  METHODS
  We evaluated 42 consecutive SLE patients with at least one active lesion attributed to lupus. Pain and pruritus were evaluated using a visual analogue scale, dermatologic QoL with the DLQI, clinical activity with the CLASI score and systemic activity with the SLEDAI-2K.
  
  
  RESULTS
  The patients were predominantly females, mean age 34.2±11.2 years and median SLE duration of 7 years. Sixteen patients (38%) had specific lesions, 12 (28.5%) non-specific lesions and 14 patients (33%) both lesions. Patients with both lesions had the highest CLASI activity scores (median 17) (p<0.0001), all the cases of severe activity (p=0.002) and higher (worst) DLQI scores (median 11.5, p=0.04). The overall median pain score was 5 (0-9). Patients with non-specific or the combination of both CLE lesions had more pain (p<0.008). Pain correlated with the DLQI (τ=0.38, p=0.001) and the CLASI activity score (τ=0.47, p=0.002). Pain was more intense in vasculitis and bullous lesions followed by oral ulcers. Pruritus score did not differ among groups (median 6) and did not correlate with the DLQI or the CLASI activity score.
  
  
  CONCLUSIONS
  We identified pain as a factor that correlated with dermatologic QoL and cutaneous activity. In this sense, this feature needs to be considered as part of the treatment targets in lupus.
authors: Department of Dermatology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico. silvia_mendezflores@live.com.mx.
authors: Silvia
authors: S
authors: Méndez-Flores
authors: Rocio
authors: R
authors: Orozco-Topete
authors: Paola
authors: P
authors: Bermúdez-Bermejo
authors: Gabriela
authors: G
authors: Hernández-Molina
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008178:Lupus Erythematosus, Cutaneous / Q000150:complications* / Q000175:diagnosis / Q000523:psychology; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000175:diagnosis / Q000209:etiology* / Q000523:psychology; D010147:Pain Measurement; D011537:Pruritus / Q000175:diagnosis / Q000209:etiology* / Q000523:psychology; D011788:Quality of Life; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires