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CE-46 Influence of solar radiation in cutaneous manifestations of lupus: data from the gladel cohort
  1. Marina Scolnik1,
  2. Luis J Catoggio1,
  3. Enrique R Soriano1,
  4. Daniel Wojdyla2,
  5. Alejandro Alvarellos3,
  6. Nilzio A Da Silva4,
  7. Eduardo Borba5,
  8. Emilia I Sato6,
  9. Antonio Iglesias7,
  10. Marlene Guibert-Toledano8,
  11. Sergio Jacobelli9,
  12. Ignacio García De La Torre10,
  13. María J Sauza11,
  14. Eduardo M Acevedo-Vásquez12,
  15. María H Esteva-Spinetti13,
  16. Graciela S Alarcón14 and
  17. Bernardo A Pons-Estel15
  1. 1Sección de Reumatología, Servicio de Clínica Médica; Hospital Italiano and Fundación Dr Pedro M. Catoggio para el Progreso de la Reumatología, Buenos Aires, Argentina
  2. 2GLADEL consultant, Rosario, Argentina
  3. 3Hospital Privado, Centro Médico de Córdoba, Córdoba, Argentina
  4. 4Faculdade de Medicina da Universidade Federal de Goiás, Goiania, Brazil
  5. 5Hospital das Clínicas da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
  6. 6Disciplina de Reumatología, Escola Paulista de Medicina, Universidade Federal da Sao Paulo -UNIFESP, Sao Paulo), Brazil
  7. 7Universidad del Bosque, Bogota, Colombia
  8. 8Centro de Investigaciones Médico Quirúrgicas-CIMEQ, Havana, Cuba
  9. 9Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
  10. 10Hospital General de Occidente de la Secretaría de Salud, Guadalajara, Jalisco, Mexico
  11. 11Instituto Mexicano de Seguro Social, Hospital de Especialidades N_25, Monterrey, Nuevo León, Mexico
  12. 12Hospital Nacional ‘‘Guillermo Almenara Irigoyen,’’ Essalud, Lima, Peru
  13. 13Hospital Central de San Cristóbal, San Cristóbal, Venezuela
  14. 14Department of Medicine, Division of Clinical Immunology and Rheumatology, School of Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, USA
  15. 15Hospital Provincial de Rosario, Rosario, Argentina


Background Whether ultraviolet radiation (UV) exposure is a risk factor for the occurrence of Systemic Lupus Erythematosus (SLE) or of flares remains unclear. Classically, it has been thought that sun exposure is a risk factor for developing cutaneous manifestations. On the other hand, in experimental studies UV radiation has a number of immunomodulatory effects and stimulates vitamin D synthesis. Our objective was to examine the mucocutaneous manifestations of SLE patients from the GLADEL cohort in relation to latitude and solar radiation of the place where they lived along Central and South America by performing an ecological study.

Materials and methods GLADEL patients were categorised according to latitude and solar radiation (insolation on horizontal surface) of the Rheumatology Centre where they were recruited, ascertained between the period of cohort follow up (1995–2004); this was obtained using NASA Surface meteorology and Solar Energy estimator ( Alopecia, photosensitivity, malar rash, discoid lesions, oral ulcers and subacute cutaneous lupus at cohort entry and during follow up were examined in multivariate models in relation to the average daily solar radiation of the city of residence (as a continuous variable) and other possible confounders.

Results The GLADEL cohort included 1480 lupus patients, with a disease duration < 2 years at entry, 89.9 % female (CI: 88–91), mean age at diagnosis 29.5 (SD 12.3), median follow up 52 months (IQR 24–70), from 34 centres of 22 cities of 9 countries in Latin America. Latitudes of these centres varied between −38° S (Mar del Plata, Argentina) and 25.7° N (Monterrey, Mexico) and mean daily solar radiation varied between 4.44 Kwh/m2/day (Porto Alegre, Brazil) and 6.08 Kwh/m2/day (Recife, Brazil). When entering the cohort, 1191 patients (80.47%) had one or more of the cutaneous manifestations mentioned above and 434 patients (29.31%) developed new skin involvement during follow?up.

In logistic regression analysis after adjusting for age, gender, ethnic group, urban residence, latitude, antimalarial use and autoantibodies, living in a city with higher daily solar radiation (examined at 1 Kwh/m²/day increments) was not associated to any of the cutaneous manifestations at disease onset or during follow up (Table 1).

Abstract CE-46 Table 1

Associations of average daily solar radiation of city of residence by multivariable logistic regression analysis*

Conclusions In the GLADEL cohort, the average solar radiation of the city of residence was not associated with an increased risk of developing cutaneous manifestations.

Acknowledgements On behalf of GLADEL group

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