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Epidemiology of Cutaneous Lupus Erythematosus Among Adults Over Four Decades (1976-2018): A Lupus Midwest Network (LUMEN) Study

Published:November 05, 2022DOI:



      To characterize the epidemiological trends and mortality of cutaneous lupus erythematosus (CLE) between 1976 and 2018 in Olmsted County, Minnesota.

      Patients and Methods

      In this retrospective population-based cohort study, all incident and prevalent CLE cases among adult residents in Olmsted County, Minnesota, between January 1, 1976, and December 31, 2018, were identified and categorized by subtype through medical record review using the resources of the Rochester Epidemiology Project.


      The overall incidence rate of CLE between 1976 and 2018 was 3.9 (95% CI, 3.4 to 4.5) per 100,000. The incidence of CLE was relatively stable, with no major trend across sexes or age groups. The age- and sex-adjusted prevalence of CLE was 108.9 per 100,000 on January 1, 2015. Mortality in CLE patients was similar to that of the general population, with a standardized mortality ratio of 1.23 (95% CI, 0.88 to 1.66) with no observed trends in mortality over time.


      In the past 4 decades, the incidence of CLE remained stable. Patients with CLE have mortality comparable to that of the general population.

      Abbreviations and Acronyms:

      CCLE (chronic cutaneous lupus erythematosus), CHLE (chilblain lupus), CLE (cutaneous lupus erythematosus), DLE (discoid lupus erythematosus), LP (lupus panniculitis), REP (Rochester Epidemiology Project), SCLE (subacute cutaneous lupus erythematosus), SLE (systemic lupus erythematosus), SMR (standardized mortality ratio), TL (tumid lupus)
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        • Werth V.P.
        Clinical manifestations of cutaneous lupus erythematosus.
        Autoimmun Rev. 2005; 4: 296-302
        • Klein R.
        • Moghadam-Kia S.
        • Taylor L.
        • et al.
        Quality of life in cutaneous lupus erythematosus.
        J Am Acad Dermatol. 2011; 64: 849-858
        • Vasquez R.
        • Wang D.
        • Tran Q.P.
        • et al.
        A multicentre, cross-sectional study on quality of life in patients with cutaneous lupus erythematosus.
        Br J Dermatol. 2013; 168: 145-153
        • Sontheimer R.D.
        The lexicon of cutaneous lupus erythematosus—a review and personal perspective on the nomenclature and classification of the cutaneous manifestations of lupus erythematosus.
        Lupus. 1997; 6: 84-95
        • Gilliam J.N.
        • Sontheimer R.D.
        Distinctive cutaneous subsets in the spectrum of lupus erythematosus.
        J Am Acad Dermatol. 1981; 4: 471-475
        • Vera-Recabarren M.A.
        • García-Carrasco M.
        • Ramos-Casals M.
        • Herrero C.
        Comparative analysis of subacute cutaneous lupus erythematosus and chronic cutaneous lupus erythematosus: clinical and immunological study of 270 patients.
        Br J Dermatol. 2010; 162: 91-101
        • Grönhagen C.M.
        • Fored C.M.
        • Granath F.
        • Nyberg F.
        Cutaneous lupus erythematosus and the association with systemic lupus erythematosus: a population-based cohort of 1088 patients in Sweden.
        Br J Dermatol. 2011; 164: 1335-1341
        • Merola J.F.
        • Prystowsky S.D.
        • Iversen C.
        • et al.
        Association of discoid lupus erythematosus with other clinical manifestations among patients with systemic lupus erythematosus.
        J Am Acad Dermatol. 2013; 69: 19-24
        • Jarukitsopa S.
        • Hoganson D.D.
        • Crowson C.S.
        • et al.
        Epidemiology of systemic lupus erythematosus and cutaneous lupus erythematosus in a predominantly white population in the United States.
        Arthritis Care Res (Hoboken). 2015; 67: 817-828
        • Durosaro O.
        • Davis M.D.P.
        • Reed K.B.
        • Rohlinger A.L.
        Incidence of cutaneous lupus erythematosus, 1965-2005: a population-based study.
        Arch Dermatol. 2009; 145: 249-253
        • Petersen M.P.
        • Möller S.
        • Bygum A.
        • Voss A.
        • Bliddal M.
        Epidemiology of cutaneous lupus erythematosus and the associated risk of systemic lupus erythematosus: a nationwide cohort study in Denmark.
        Lupus. 2018; 27: 1424-1430
        • Baek Y.S.
        • Park S.H.
        • Baek J.
        • Roh J.Y.
        • Kim H.J.
        Cutaneous lupus erythematosus and its association with systemic lupus erythematosus: a nationwide population-based cohort study in Korea.
        J Dermatol. 2020; 47: 163-165
        • Drenkard C.
        • Parker S.
        • Aspey L.D.
        • et al.
        Racial disparities in the incidence of primary chronic cutaneous lupus erythematosus in the southeastern US: the Georgia Lupus Registry.
        Arthritis Care Res (Hoboken). 2019; 71: 95-103
        • Deligny C.
        • Clyti E.
        • Sainte-Marie D.
        • et al.
        Incidence of chronic cutaneous lupus erythematosus in French Guiana: a retrospective population-based study.
        Arthritis Care Res (Hoboken). 2010; 62: 279-282
        • Hesselvig J.H.
        • Ahlehoff O.
        • Dreyer L.
        • Gislason G.
        • Kofoed K.
        Cutaneous lupus erythematosus and systemic lupus erythematosus are associated with clinically significant cardiovascular risk: a Danish nationwide cohort study.
        Lupus. 2017; 26: 48-53
      1. Duarte-García A, Hocaoglu M, Valenzuela-Almada M, et al. Rising incidence and prevalence of systemic lupus erythematosus: a population-based study over four decades [published online ahead of print May 16, 2022]. Ann Rheum Dis.

        • St Sauver J.L.
        • Grossardt B.R.
        • Yawn B.P.
        • Melton III, L.J.
        • Rocca W.A.
        Use of a medical records linkage system to enumerate a dynamic population over time: the Rochester Epidemiology Project.
        Am J Epidemiol. 2011; 173: 1059-1068
        • St Sauver J.L.
        • Grossardt B.R.
        • Leibson C.L.
        • Yawn B.P.
        • Melton III, L.J.
        • Rocca W.A.
        Generalizability of epidemiological findings and public health decisions: an illustration from the Rochester Epidemiology Project.
        Mayo Clin Proc. 2012; 87: 151-160
        • St Sauver J.L.
        • Grossardt B.R.
        • Yawn B.P.
        • et al.
        Data resource profile: the Rochester Epidemiology Project (REP) medical records-linkage system.
        Int J Epidemiol. 2012; 41: 1614-1624
        • Grönhagen C.M.
        • Nyberg F.
        Cutaneous lupus erythematosus: an update.
        Indian Dermatol Online J. 2014; 5: 7-13
        • Ruiz H.
        • Sánchez J.L.
        Tumid lupus erythematosus.
        Am J Dermatopathol. 1999; 21: 356-360
        • Aringer M.
        • Costenbader K.
        • Daikh D.
        • et al.
        2019 European League Against Rheumatism/American College of Rheumatology classification criteria for systemic lupus erythematosus.
        Arthritis Rheumatol. 2019; 71: 1400-1412
        • Duarte-García A.
        • Hocaoglu M.
        • Osei-Onomah S.-A.
        • et al.
        Population-based incidence and time to classification of systemic lupus erythematosus by three different classification criteria: a Lupus Midwest Network (LUMEN) study.
        Rheumatology (Oxford). 2022; 61: 2424-2431
        • Duval S.
        • Jacobs Jr., D.R.
        • Barber C.
        • et al.
        Trends in cigarette smoking: the Minnesota Heart Survey, 1980-1982 through 2000-2002 [published correction appears in Nicotine Tob Res. 2008;10(11):1669-1670].
        Nicotine Tob Res. 2008; 10: 827-832
      2. Sontheimer R.D. Provost T.T. Cutaneous Manifestations of Rheumatic Diseases. Williams & Wilkins, 1996