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389916

Prognostic Value of Livedo Reticularis and Raynaud’s Phenomenon in Systemic Lupus Erythematosus Patients

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Last updated: 01 Jan 2025

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Abstract

Abstract Background: Systemic lupus erythematosus is a chronic multisystem autoimmune inflammatory disease. Skin is con-sidered as the second most commonly affected organ in lupus patients. Livedo reticularis and Raynaud's phenomenon are considered as cutaneous vascular manifestations of nonspecific skin changes that occur in systemic lupus erythematosus. Aim of Study: This study aims to examine the frequency of Raynaud's phenomenon and livedo reticularis in SLE patients and its relation to disease outcomes. Patients and Methods: This study is a post hoc analysis of previous study titled (Disease characteristics in patients with juvenile- and adult-onset systemic lupus erythematosus) con-ducted in Kasr Al-Aini Medical Hospital from October 2023 to April 2024. In the current study we retrospectively analyzed medical records of a total of 422 SLE patients, according to presence or absence of livedo reticularis and Raynaud's phe-nomenonpatients were divided in groups, and comparative studies between groups were conducted regarding demograph-ic, clinical, and laboratory parameters. Furthermore, groups were compared regarding SLE Disease Activity Index (SLE-DAI), and the Systemic Lupus International Collaborating Clinics/American College Rheumatology Damage Index scores (SLICC). Results: The mean of disease duration was 9.7±6.7. Livedo reticularis and Raynaud's were more frequent in juvenile on-set lupus patients (p=0.043, p=0.002). Livedo reticularis and Raynaud's patients showed statistically significant higher fre-quency of thrombosis (p<0.001, p=0.004), secondary vasculi-tis (p=0.017, p<0.001), digital gangrene (p<0.001, p=0.003), more frequent APL Antibodies (p=0.013, p=0.005) and high-er damage index (p<0.001, p=0.031). Livedo patients showed statistically significant higher frequency of neuropsychiatric manifestations (NP), musculoskeletal manifestations, Hypo-complementemia (p<0.001, p=0.036, p=0.039), and higher fre-quency of dyslipidemia and renal failure (p=0.011, p=0.040), while Raynaud's patients showed higher frequency of avascular necrosis (p=0.001). On comparing Patients with livedo and/or Raynaud's to those without, patients with livedo and or raynaud's showed statistically significant higher SLICC damage index (p=0.018), secondary vasculitis (p<0.001), NP (p=0.036), thrombosis (p=0.002), and more frequent APL antibodies (p=0.003). Conclusion: Lupus patients with Raynaud's and/or livedo reticularis may be associated worse disease outcomes and high-er damage index.

DOI

10.21608/mjcu.2024.389916

Keywords

Livedo reticularis, Raynaud’s phenomena, SLICC damage index, SLE

Authors

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AHMED M. SOLIMAN, M.D.1; DOAA M. KHALIL, M.D.2; YASMIN B. EL ZAWAHRY, M.D.1;

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MAZEN ATIA, M.D.3; MAHMOUD M. ISMAIL, M.D.4; DINA A EFFAT, M.D.5; IBRAHEM SIAM, M.D.6;

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SHERIF M. GAMAL, M.D.5

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and MARWA TANTAWY, M.D.7

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Affiliation

The Department of Dermatology & Venereology, National Research Centre1, Public Health & Community Medicine, Beni-Suef University2, Department of Internal Medicine, Cairo University3, Rheumatology and Rehabilitation, Military Medical Academy4, Rheumatology Department, Cairo University, Faculty of Medicine5, Department of Internal Medicine, National Research Centre6 and Rheumatology Department, Beni-Suef University7

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Volume

92

Article Issue

09

Related Issue

51209

Issue Date

2024-09-01

Receive Date

2024-10-31

Publish Date

2024-09-01

Page Start

899

Page End

905

Print ISSN

0045-3803

Online ISSN

2536-9806

Link

https://mjcu.journals.ekb.eg/article_389916.html

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https://mjcu.journals.ekb.eg/service?article_code=389916

Order

389,916

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Original Article

Type Code

263

Publication Type

Journal

Publication Title

The Medical Journal of Cairo University

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https://mjcu.journals.ekb.eg/

MainTitle

Prognostic Value of Livedo Reticularis and Raynaud’s Phenomenon in Systemic Lupus Erythematosus Patients

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Article

Created At

30 Dec 2024