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Racial Disparities in the Incidence of Primary Chronic Cutaneous Lupus Erythematosus in the Southeastern United States: The Georgia Lupus Registry
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January 2019
Source: Arthritis Care Res (Hoboken). 71(1):95-103
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Alternative Title:Arthritis Care Res (Hoboken)
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Description:Objective
Relative to SLE, epidemiologic studies on chronic cutaneous lupus erythematosus (CCLE) are rare and limited to populations without racial diversity. We sought to provide minimum estimates of the incidence of primary CCLE (CCLE in absence of SLE) in a predominantly white and black population in the Southestern United States.
Methods
The Georgia Lupus Registry used multiple sources for case finding, including dermatology and rheumatology practices, multispecialty healthcare facilities, and dermatopathology reports. Cases with a clinical or clinical-histological diagnosis of CCLE were classified as definite. Cases ascertained exclusively from dermatopathology reports were categorized as probable. Age-standardized incidence rates stratified by sex and race were calculated for discoid lupus erythematosus (DLE) in particular and for CCLE in general.
Results
The overall age-adjusted estimates for combined (definite and probable) CCLE were 3.9/100,000 person-years (95% CI: 3.4,4.5). The overall age-adjusted incidence of definite and combined DLE were 2.9 (95% CI: 2.4,3.4) and 3.7 (95% CI: 3.2,4.3) per 100,000 person-years, respectively. With capture-recapture methods, the age-adjusted incidence of definite DLE increased to 4.0 (95% CI: 3.2,4.3). Black-to-white and female-to-male incidence ratios were 5.4 and 3.1 for definite DLE.
Conclusion
Our findings underscore striking racial disparities in the susceptibility for primary CCLE, with black people experiencing between three and five-fold increased incidence of CCLE in general and DLE in particular, compared to white people. Gender differences were consistent with those reported previously, with a three times higher risk of DLE in females compared to males.
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Pubmed ID:29669194
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Pubmed Central ID:PMC6193862
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