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167 Clinical evaluation of systemic lupus erythematosus patients for skin lesions-report from a developing country
  1. Z Haider1,
  2. MN Islam2,
  3. A Asaduzzaman3,
  4. N Ferdous4 and
  5. JJH Rasker5
  1. 1BSMMU, Rheumatology, Dhaka, Bangladesh
  2. 2BSMMU and MOACandRC, Rheumatology, Dhaka, Bangladesh
  3. 3BSMMU, Dermatology, Dhaka, Bangladesh
  4. 4MOACandRC, Rheumatology, Dhaka, Bangladesh
  5. 5University of Twente, Psychology- Health and Technology, Enschede, Netherlands Antilles

Abstract

Background and aims SLE patients often suffer from both specific, non specific skin lesions and infections. This study was aimed to observe frequency of lupus specific and non-specific skin lesions, skin infections and factors related to infections.

Methods This observational study was conducted in SLE clinic of BSMMU, Bangladesh. A total 148 patients were enrolled and followed for 1 year. Patients were evaluated at baseline, special and final visits. Clinical definitions and dermatologist opinion were used for diagnosis of skin lesions. Patient’s demographics, SLE lesions, infection as well as relevant laboratory tests were recorded. Multivariate analysis was done for risk factors. Ethical clearance was obtained from IRB of BSMMU.

Results A total 131patients (126 women and 5 men) completed the study period; their mean age was 28.75±8.17 years. Frequency of skin lesions and infections were 71.76% (94) and 26.7% (35) respectively. Specific lupus lesions were malar rash 75.44% followed by DLE, 15.78%. Photosensitivity (72.6%), non-scaring alopecia (67.9%), mucosal ulcer (47.6%), raynaud’s phenomenon (23.8%) and hyper-pigmentation (23.8%) were notable non-specific skin lesions. Common skin infections were tineasis (42.85%), herpes infections (34.26%), paronychia (20%) and scabies (17%). High SLEDAI score, low complements, prednisolone (>10 mg/day) and use of immunosuppressive agents at present or in past were found risk factors for skin infections.

Conclusions Skin infections were high in this study. Tineasis, herpes infections, paronychia and scabies were common. Active disease, use of prednisolone >10 mg/day and immunosuppressive therapy were observed risk factors. Vaccinations and judicious use of drugs might reduce the rate of skin infection.

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