The Cutaneous Lupus Erythematosus Disease Area and Severity Index
The Cutaneous Lupus Erythematosus Disease Area and Severity Index
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DOI：
10.1001/archderm.144.2.173
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发表时间：
2008-02-01
影响因子：
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通讯作者：
Werth, Victoria P.
中科院分区：
文献类型：
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作者：
Bonilla-Martinez, Zuleika L.;Albrecht, Joerg;Werth, Victoria P.
目的：评估CLASI的临床反应性（皮肤红斑狼疮[CLE]疾病面积和严重程度指数）。设计：验证队列。设置：三级转诊中心。患者：8名CLE患者。干预：评估CLE患者从基线到开始新标准护理治疗后第56天的情况。主要结果测量：2个CLASI量表中基线与第56天变化的相关性（疾病活动性和损伤），以及医生和患者对患者的总体皮肤健康评分的评估以及患者对疼痛和瘙痒的评估的基线至第56天的变化。CLASI活动评分的变化与3个临床验证指标的变化高度相关：医生对皮肤健康的评估（r=0.97; P= 0.003; n=7），患者的整体皮肤健康评分（r=0.85; P= 0.007; n=8）和疼痛（r=0.98; P= 0.004; n=5）。使用Wilcoxon符号秩检验，分析了组成每个验证变量的2个亚组（有意义变化vs无意义变化）的CLASI活动和损伤评分的配对基线至第56天变化。CLASI活性的变化在总体皮肤自我评分有意义变化的患者中有显著差异（Z = 1.07; P= 0.03），在瘙痒水平有意义变化的患者中接近统计学显著性（Z= 1.83; P= 0.06）和医生的总体皮肤评分（Z= 1.84; P= 0.06）。CLASI活动评分降低成功的治疗干预后，而损伤评分可能会增加疤痕形式的CLE.Conclusion：CLASI的活动评分与全球皮肤健康，疼痛和瘙痒的改善，因此是一个有用的工具来衡量临床反应。
Objective: To assess the clinical responsiveness of the CLASI (Cutaneous Lupus Erythematosus [CLE] Disease Area and Severity index).Design: Validation cohort.Setting: Tertiary referral center.Patients: Eight patients with CLE.Intervention: Assessment of patients with CLE from baseline until day 56 after starting a new standard of care therapy.Main Outcome Measures: Correlation of the baseline to day-56 change in 2 CLASI scales (disease activity and damage), with baseline to day-56 change in the physicians' and patients' assessments of patient's global skin health scores, and the patients'assessments of pain and itch.Results: The change in CLASI activity score highly correlated with the changes in 3 clinical validation measures: physicians' assessment of skin health (r=0.97; P=.003; n=7), patients' global skin health score (r=0.85; P=.007; n=8), and pain (r=0.98; P=.004; n=5). Using the Wilcoxon signed-rank test, paired baseline to day-56 changes in CLASI activity and damage scores were analyzed for the 2 subgroups (meaningful change vs nonmeaningful change) composing each validation variable. Change in CLASI activity was significantly different for patients who had a meaningful change in their global skin self-ratings (Z = 1.07; P=.03) and approached statistical significance for patients who had a meaningful change in their level of itching (Z= 1.83; P=.06) and their physicians' global skin rating (Z= 1.84; P=.06). The CLASI activity score decreases after successful therapeutic intervention, whereas the damage score may increase in scarring forms of CLE.Conclusion: The activity score of the CLASI correlates with the improvement of global skin health, pain, and itch and is thus a useful tool to measure clinical response.