{
  "abstract": "Cutaneous lupus erythematosus (CLE) has a large impact on quality of life (QoL). The goal of remission is important, but until recently has been difficult to achieve for many patients. There is now a validated score for CLE, the cutaneous lupus area and severity index (CLASI) score, which can measure both disease activity and damage in two separate scores. 1–3 It correlates with QoL and biomarkers of CLE activity, and a meaningful improvement from patient perspective is thought to be 50% improvement in the CLASI activity score. Complete remission needs to be considered as on medication or off medication, and remission off medication is much less frequent. In addition, CLE often flares in the summer after sun exposure, so a patient may be disease free, but then flare. The role of length of time with no lesions is a consideration in terms of remission. Finally, measuring complete remission with the CLASI or an investigator global assessment (CLA-IGA)4 can be difficult since some degree of residual erythema due to telangiectasias and potentially dyspigmentation masking activity can pose challenges to assessing low degrees of CLE activity. A linear relationship has been observed between decreasing CLE activity and improved QoL until a CLASI-A score of 3 is reached. Below this threshold, further reductions in CLE activity yield negligible additional improvements in QoL. The data and complexities of determining remission will be discussed.Learning Objectives At the end of this presentation participants will be able to:Discuss ways to measure cutaneous activity and remission.Explore examples of remissionDescribe what is meaningful in terms of remission from a patient perspectiveReferences Chakka S, Krain RL, Ahmed S, et al. Evaluating change in disease activity needed to reflect meaningful improvement in quality of life for clinical trials in cutaneous lupus erythematosus. J Am Acad Dermatol. 2021;84(6):1562–67. doi: 10.1016/j.jaad.2020.07.047Chakka S, Krain RL, Concha JSS, et al. The clasi, a validated tool for the evaluation of skin disease in lupus erythematosus: a narrative review. Ann Transl Med. 2021;9(5):431. doi: 10.21037/atm-20-5048Tarazi M, Gaffney RG, Feng R, et al. Evaluating cutaneous lupus disease activity end points and their effects on quality of life as an outcome measure for clinical trials. Br J Dermatol. 2019;181(4):841–42. doi: 10.1111/bjd.17926Merola JF, Zhang AJ, Childs BA, et al. Inter-rater and intra-rater reliability of the cutaneous lupus activity-investigator global assessment-revised instrument. J Invest Dermatol. 2025;145(8):2085–88.e2. doi: 10.1016/j.jid.2025.01.020",
  "authors": [
    {
      "affiliations": [
        "University of Pennsylvania Perelman School of Medicine and Philadelphia VAMC, Philadelphia, USA"
      ],
      "name": "Victoria Werth"
    }
  ],
  "title": "17 Lupus skin and remission: the dermatologist’s perspective",
  "uid": "a5fdf089-a6ba-532b-b096-233475096f8f"
}