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Mucocutaneous Disease Activity and Damage Accrual in Systemic Lupus Erythematosus: Analyses From the Asia-Pacific Lupus Collaboration Longitudinal Cohort Study

Saracino AM 1 , Hao Y 2 , Hansen D 3 , Chen YH 4 , Hoi A 5 , Golder V 5 Show all authors , Cho J 6 , Lateef A 7 , Louthrenoo W 8 , Hamijoyo L 9 , Luo SF 10 , Wu YJ 10 , Navarra S 11 , Zamora L 11 , Lau CS 12 , Chan S 12 , Li Z 13 , Yao HH 13 , Sockalingam S 14 , Basnayake BMDB 15 , Katsumata Y 16 , Harigai M 16 , Zhang Z 17 , Kikuchi J 18 , Kaneko Y 18 , Takeuchi T 18 , Chan M 19 , Bae SC 20 , Goldblatt F 21 , O'Neill S 22 , Hassett G 22 , Ng K 23 , Tugnet N 24 , Sapsford M 25 , Poh YJ 26 , Tee M 27 , Tee C 28 , Ohkubo N 29 , Tanaka Y 28 , Kandane-Rathnayake R 5 , Morand E 5 , Oon S 2 , Nikpour M 3

Affiliations 

  • 1 Department of Dermatology, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia
  • 2 Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
  • 3 Department of Rheumatology, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia
  • 4 Division of Allergy, Immunology, and Rheumatology, Taichung Veterans General Hospital, Taichung, Taiwan
  • 5 Rheumatology Research Group, Centre for Inflammatory Diseases, School of Clinical Sciences, Monash University, Clayton, Victoria, Australia
  • 6 Rheumatology Division, Department of Medicine, National University Hospital, Singapore
  • 7 Department of Medicine, Woodlands Health, Singapore
  • 8 Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University Hospital, Chiang Mai, Thailand
  • 9 Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Padjadjaran University/Hasan Sadikin General Hospital, Bandung, Indonesia
  • 10 Department of Rheumatology, Allergy, and Immunology, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan City, Taiwan
  • 11 Section of Rheumatology, University of Santo Tomas Hospital, Manila, Philippines
  • 12 Division of Rheumatology and Clinical Immunology, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Pok Fu Lam, Hong Kong
  • 13 Department of Rheumatology and Immunology, People's Hospital, Peking University Health Science Center, Beijing, China
  • 14 Department of Medicine, Faculty of Medicine, University of Malaya Medical Center, Kuala Lumpur, Malaysia
  • 15 Department of Nephrology, Teaching Hospital, Kandy, Sri Lanka
  • 16 Department of Rheumatology, Tokyo Women's Medical University School of Medicine, Tokyo, Japan
  • 17 Rheumatology and Immunology Department, Peking University First Hospital, Beijing, China
  • 18 Department of Internal Medicine, Keio University, Tokyo, Japan
  • 19 Department of Rheumatology, Allergy, and Immunology, Tan Tock Seng Hospital, Singapore
  • 20 Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Hanyang University Institute for Rheumatology Research, Hanyang Institute of Bioscience and Biotechnology, Seoul, Korea
  • 21 Department of Rheumatology, Flinders Medical Centre, Bedford Park, South Australia, Australia
  • 22 Department of Rheumatology, Liverpool Hospital, Sydney, New South Wales, Australia
  • 23 Department of Rheumatology, Health New Zealand Waitemata, Te Whatu Ora, Auckland, New Zealand
  • 24 Department of Rheumatology, Health New Zealand Auckland, Te Whatu Ora (Greenlane Clinical Centre) Auckland, New Zealand
  • 25 Department of Rheumatology, Health New Zealand Counties Manukau, Te Whatu Ora (Middlemore Hospital), Auckland, New Zealand
  • 26 Department of Rheumatology and Immunology, Singapore General Hospital, Singapore
  • 27 University of the Philippines, Manila, Philippines
  • 28 University of Occupational and Environmental Health, Kitakyushu, Japan
  • 29 The University of Sydney School of Public Health, Sydney, New South Wales, Australia
Arthritis Care Res (Hoboken), 2026 Nov;78(11):1608-1617.
PMID: 41940438 DOI: 10.1002/acr.80050

Abstract

OBJECTIVE: This research article aims to describe the prevalence, associations, and health-related quality of life (HRQoL) impact of mucocutaneous features of systemic lupus erythematosus (SLE).

METHODS: Data from the Asia-Pacific Lupus Collaboration cohort were analyzed (2013-2021). Mucocutaneous activity (MC-A) items were rash, alopecia, and mucosal ulcers; were defined by the Systemic Lupus Erythematosus Disease Activity Index 2000; and were persistent if present for at least six months. Mucocutaneous damage (MC-D) items were chronic skin ulceration, scarring alopecia, and skin/panniculum scarring and were defined by the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index. HRQoL was measured by 36-Item Short Form Health Survey (SF-36) surveys. Multivariate logistic generalized estimating equation models were used to determine correlates of MC-A at each visit. Time-varying covariate survival models were used to determine predictors of MC-D.

RESULTS: During a median of 2.5 (interquartile range 1.0-5.1) years' follow-up, 1,499 of 4,102 patients (36.5%) had MC-A (rash n = 1,055, alopecia n = 731, mucosal ulcers n = 352) and 606 of 3,655 patients (16.6%) had persistent MC-A. These patients were more likely to record worse mean mental (42.6 vs 44.8; P = 0.014) and physical component (41.1 vs 46.1; P 

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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