by UT Southwestern Medical Center

Credit: Pixabay/CC0 Public Domain

Patients with cutaneous lupus erythematosus (CLE), an autoimmune disease that causes skin inflammation, have a higher risk for atherosclerotic cardiovascular disease (ASCVD), or hardening of the arteries, UT Southwestern Medical Center researchers found. Their study, published in JAMA Dermatology, suggests CLE patients should be screened early for heart disease.

“While it has been well established that patients with systemic lupus erythematosus (SLE) are at higher risk for cardiovascular disease, those with cutaneous lupus, who generally fall in the milder spectrum of lupus disease, had little clarity about their chances of developing significant heart disease,” said senior author Benjamin Chong, M.D., Professor of Dermatology. “This study helps shed light on this knowledge gap and encourages providers to discuss this potential risk with their patients with cutaneous lupus.”

CLE affects at least 80% of people who have SLE, but it can also occur alone. The Centers for Disease Control and Prevention estimates that 204,000 people in the United States have SLE. Although SLE and psoriasis—an inflammatory skin condition—have been linked to an increased risk of atherosclerotic cardiovascular disease, a similar link involving CLE has been less clear.

Using the IBM MarketScan Commercial Claims and Encounters Database, UTSW researchers analyzed data from 306,770 adults over 18 years of age. Each individual was identified as having CLE, SLE, or psoriasis based on International Classification of Diseases (ICD-10) codes and evaluation by a dermatologist or rheumatologist, excluding patients with overlap between diseases.

For the three disease groups, researchers compared the prevalence of ASCVD and the incidence of newly diagnosed ASCVD. In addition, the association between CLE severity and ASCVD was investigated. Results showed that both the prevalence and incidence of cardiovascular disease in patients with CLE was similar to that of patients with SLE and higher than those with psoriasis and age-matched, disease-free controls.

After controlling for cardiovascular disease risk factors, the study found no increased risk in adults with psoriasis. However, adults with more severe cases of CLE who were on systemic therapy experienced a higher prevalence and incidence of cardiovascular disease than those with mild CLE, who received no treatment or only topical treatments.

“Our findings suggest clinicians treating individuals with CLE should consider them at increased risk for ASCVD and evaluate them accordingly,” said lead author Henry Chen, M.D., a UT Southwestern resident in Dermatology.

More information: Henry W. Chen et al, Incidence and Prevalence of Atherosclerotic Cardiovascular Disease in Cutaneous Lupus Erythematosus, JAMA Dermatology (2024). DOI: 10.1001/jamadermatol.2024.4991

Journal information:JAMA Dermatology

Provided by UT Southwestern Medical Center

---

Explore further

Age, race impact atherosclerotic risk with psoriasis