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Skin signs in juvenile- and adult-onset systemic lupus erythematosus: clues to different systemic involvement

机译：少年和成人发病系统狼疮红斑狼疮的皮肤症状：不同系统参与的线索

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Objective We aim to explore the differences of skin signs between juvenile- and adult-onset systemic lupus erythematosus and to identify their associations to the development of systemic involvement. Methods A retrospective chart review of 377 systemic lupus erythematosus patients was performed. Results In total, 171 patients with juvenile systemic lupus erythematosus and 206 with adult systemic lupus erythematosus were studied. All patients were of Southeast Asian descent. The mean duration of follow up was 8.18 +/- 6.19 and 9.36 +/- 7.68 years for juvenile systemic lupus erythematosus and adult systemic lupus erythematosus, respectively. At diagnosis, most patients presented with acute cutaneous lupus erythematosus, whereas chronic cutaneous lupus erythematosus was twice as common in adult systemic lupus erythematosus (p 0.001). The mean Systemic Lupus Erythematosus Disease Activity Index of juvenile systemic lupus erythematosus was significantly higher than that of adult systemic lupus erythematosus (14.29 +/- 7.13 vs 11.27 +/- 6.53). Multivariate analysis revealed the following associations in juvenile systemic lupus erythematosus: acute cutaneous lupus erythematosus and non-scarring alopecia with increased risk of arthralgia, mucosal ulcers with leukopenia, cutaneous vasculitis with seizure, and finding of granular casts. On the contrary, the associations for adult systemic lupus erythematosus were oral ulcers with arthralgia and cutaneous vasculitis with myositis. Conclusions Cutaneous signs in systemic lupus erythematosus may signal prognostic implication. Interestingly, despite similar cutaneous lesions in systemic lupus erythematosus, different ages of onset are associated with different systemic involvement.
机译：目标我们的目标是探讨少年和成人发病系统狼疮红斑狼疮的皮肤迹象的差异，并确定其与系统参与发展的协会。方法进行377株狼疮患者的回顾图综述。研究了171例少年全身性狼疮患者和206例成人全身狼疮红斑狼疮。所有患者都是东南亚血统。少年全身狼疮红斑狼疮和成人全身狼疮红斑狼疮的平均持续时间为8.18 +/- 6.19和9.36 +/- 7.68年。在诊断中，大多数患者患有急性皮肤狼疮红斑狼疮，而慢性皮肤狼疮红斑狼疮是成人全身狼疮红斑狼疮的两倍（P <0.001）。少年全身狼疮红斑狼疮的平均全身狼疮性疾病疾病指数显着高于成人全身性红斑狼疮（14.29 +/- 7.13 Vs 11.27 +/- 6.53）。多变量分析揭示了少年全身性狼疮红斑狼疮的联想：急性皮肤狼疮红斑狼疮和非瘢痕疮，随着关节痛，粘膜溃疡的风险增加，白细胞溃疡，皮肤血管炎，癫痫发作的皮肤血管炎以及颗粒状铸造。相反，成人系统性狼疮红斑狼疮的关联是口腔溃疡，具有肌炎的关节痛和皮肤血管炎。结论Systemic Lupus红斑狼疮的皮肤迹象可能发出预后意蕴。有趣的是，尽管系统性狼疮红斑狼疮中的类似皮肤病变，但不同年龄的发病症与不同的系统性受累有关。

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