The following is a summary of “Risk factors of progression from discoid lupus to severe systemic lupus erythematosus: a registry-based cohort study of 164 patients,” published in the MARCH 2023 issue of Dermatology by Fredeau, et al.

The risk factors for progression from discoid lupus erythematosus (DLE) to severe systemic lupus erythematosus (sSLE) have not been studied previously. Therefore, for a study, researchers sought to identify these risk factors and create a predictive score for progression to sSLE in patients with isolated DLE or those with mild biological abnormalities associated with systemic lupus erythematosus. 

The study was conducted on a registry-based cohort, and a multivariable analysis was performed to identify relevant variables. The number of points in the predictive score was weighted proportionally to the odds ratio (OR).

The study included 30 patients with DLE who developed sSLE and 134 patients who did not. Among the 12 selected variables, three risk factors were identified in the multivariable analysis. These were an age of <25 years at the time of DLE diagnosis (OR, 2.8; 95% CI, 1.1-7.0; 1 point), phototype V to VI (OR, 2.7; 95% CI, 1.1-7.0; 1 point), and antinuclear antibody titers of ≥1:320 (OR, 15; 95% CI, 3.3-67.3; 5 points). These factors were used to create a predictive score. None of the 54 patients with a score of 0 at baseline progressed to sSLE, whereas a score of ≥6 was associated with a risk of approximately 40%.

In conclusion, an age of <25 years at the time of DLE diagnosis, phototype V to VI, and antinuclear antibody titers of ≥1:320 were identified as risk factors for developing sSLE. The predictive score could be used to identify patients at high progression risk and initiate appropriate interventions.