TOPLINE

Patients with drug-induced subacute cutaneous lupus erythematosus (DI-SCLE) who progressed to systemic lupus erythematosus (SLE) presented more commonly with systemic features such as arthralgias, cytopenias, or alopecia, or tested positive for anti-double-stranded DNA (anti-dsDNA) or anti-Smith antibodies, in a study.

METHODOLOGY

• A retrospective cohort study analyzed adults diagnosed with DI-SCLE (mean age at diagnosis, 63 years; 84% were women; and 93% were White) between 2015 and 2025 at Mass General Brigham institutions in Boston.
• A total of 45 patients were included, with DI-SCLE defined as clinician-documented disease with onset temporally related to a suspected culprit drug; 42 patients had supportive biopsies.
• Patients were stratified into two groups: those who progressed to SLE (n = 5) and those who remained DI-SCLE-only (n = 40). Mean time for progression was 6.7 months.
• Clinical and serologic data, including antinuclear antibody (ANA), anti-Sjögren syndrome–related antigen A (anti-SSA), anti-dsDNA, and anti-Smith antibodies were analyzed.
• Median follow-up was 61 months.

TAKEAWAY

• Anti-dsDNA antibodies were significantly more prevalent in the SLE-progression group compared with the DI-SCLE-only group (60% vs 3%; P < .05).
• Anti-Smith antibodies were also significantly more common in the SLE-progression group (60% vs 4%; P < .05).
• Systemic symptoms at DI-SCLE diagnosis were more frequent in the SLE-progression group, including arthralgias (60% vs 5%; P = .007), leukopenia (60% vs 0%; P < .001), thrombocytopenia (60% vs 0%; P < .001), and alopecia (40% vs 3%; P = .029).

IN PRACTICE

"[E]arly serologic evaluation may be valuable in patients with systemic features, and longitudinal surveillance may be warranted in those with systemic features or SLE-specific serologies." The authors wrote. "Whether these features identify a higher-risk phenotype requires confirmation in larger cohorts."

SOURCE

The study was led by Maureen Whittelsey, BS, and Jessica Orofino, MS, Brigham and Women's Hospital, Boston. It was published online on September 15 in the Journal of the American Academy of Dermatology.

LIMITATIONS

The retrospective design, small number of patients in the SLE-progression subgroup, and inclusion of predominantly White non-Hispanic cohort were study limitations. 

DISCLOSURES

No specific funding was reported for the study. One author reported receiving research funding and consulting fees from multiple pharmaceutical and consulting companies, including Pfizer and Merck. Full author disclosures are reported in the original article.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.