The relationship between disease severity and quality of life in discoid lupus erythematosus

Conflicts of interest: none declared. Dear Editor, Discoid lupus erythematosus (DLE) is a chronic scarring skin condition and a subset of cutaneous lupus as defined by Gilliam and Sontheimer.1 It is a common form of cutaneous lupus erythematosus in a European population.2 The objective of this study was to assess the effect of DLE severity on quality of life. Quality of life was measured by the patient using the Dermatology Life Quality Index (DLQI) and was correlated with the severity of their disease objectively assessed by the Cutaneous Lupus Disease Area and Severity Index (CLASI). CLASI is a validated tool that enables physicians to assign a score to the severity of cutaneous lupus.3 An activity score is calculated from the degree and area of erythema, scale and hypertrophy, mucous membrane involvement and alopecia. A damage score is calculated from the dyspigmentation and scarring seen. The DLQI is a validated measure of quality of life with a maximum score of 30, with increasing score indicating an increasing impact on quality of life.4 Additionally, Māori and Pacific Island patients were examined as a combined specific subgroup, as in New Zealand, Māori and Pacific Island patients are at particular risk of DLE, with an age‐ and sex‐adjusted relative risk of 5·96 [95% confidence interval (CI) 3·06–11·6] compared with European New Zealanders.5