Impact of Smoking in Cutaneous Lupus Erythematosus

被引:77
作者
Piette, Evan W. [2 ]
Foering, Kristen P. [2 ]
Chang, Aileen Y. [2 ]
Okawa, Joyce [2 ]
Ten Have, Thomas R. [2 ,3 ]
Feng, Rui [2 ,3 ]
Werth, Victoria P. [1 ,2 ,3 ]
机构
[1] Univ Penn, Sch Med, Dept Dermatol, Perelman Ctr Adv Med, Philadelphia, PA 19104 USA
[2] Philadelphia VA Med Ctr, Philadelphia, PA USA
[3] Univ Penn, Ctr Clin Epidemiol & Biostat, Philadelphia, PA 19104 USA
基金
美国国家卫生研究院;
关键词
CIGARETTE-SMOKING; ALCOHOL-CONSUMPTION; TOBACCO-SMOKE; ASSOCIATION; RISK; TUMIDUS; MARKERS; LESIONS;
D O I
10.1001/archdermatol.2011.342
中图分类号
R75 [皮肤病学与性病学];
学科分类号
100206 ;
摘要
Objective: To investigate cigarette smoking in cutaneous lupus erythematosus (CLE). Design: Prospective longitudinal cohort study. Setting: Urban cutaneous autoimmune disease clinic. Participants: A total of 218 individuals with CLE or systemic lupus erythematosus and lupus nonspecific skin disease seen between January 5, 2007, and July 30, 2010. Main Outcome Measures: Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI) scores to assess disease severity and response to treatment and Skindex 29+3 scores to assess patient quality of life. Results: Current smokers with lupus erythematosus had higher median CLASI scores (9.5) than did never (7.0) and past (6.0) smokers with CLE (P = .02). Current smokers had higher median scores on all the Skindex 29+3 subsets. Current smokers taking hydroxychloroquine sulfate had higher quinacrine hydrochloride use than did nonsmokers (P = .04). Two to 7 months after enrollment, current smokers (median CLASI change, 3) treated with only antimalarial agents improved more than never (1) and past (0) smokers (P = .02). Eight months or more after enrollment, current smokers (CLASI change, 3.5) treated with antimalarial drugs plus at least 1 additional immunomodulator improved less than never (-1.5) and past (0) smokers (P = .04). Conclusions: Current smokers with lupus erythematosus had worse disease, had worse quality of life, and were more often treated with a combination of hydroxychloroquine and quinacrine than were nonsmokers. Never and past smokers showed greater improvement when treated with antimalarial agents plus at least 1 additional immunomodulator. Current smokers had greater improvement when treated with antimalarial drugs only.
引用
收藏
页码:317 / 322
页数:6
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