{
  "abstract": "Objectives Cutaneous manifestations are among the most frequent and clinically significant features of systemic lupus erythematosus (SLE), occurring in approximately 70–85% of patients during the disease course. Identifying the mechanisms driving the persistence of cutaneous activity is essential for refining disease monitoring, tailoring therapeutic approaches, and preventing long-term skin damage. The aim of this study was to identify clinical and immunological predictors associated with the persistence of active cutaneous lesions in patients with SLE.Methods The study included 210 patients (177 women and 33 men) with a median age of 35.0 [26.0–43.0] years. Cutaneous manifestations were observed in 106 patients (50%). After six months of follow-up, 116 out of 210 patients were re-evaluated, and 25 of them (21.6%) had persistent active skin lesions. A predictive model was developed using binary logistic regression. The variables included R-CLASI and CLASI-AI scores, positivity for anti-Ro/SS-A, anti-dsDNA, and anti-Sm antibodies, combined positivity for anti-dsDNA and anti-Sm, decreased C3 and C4 complement levels, SLEDAI-2K, PGA, SLE-DAS, the mucocutaneous domain of Easy-BILAG, kidney involvement, photosensitivity, serositis, and hematological disorders.Results The relationship between variables is described by the regression equation ( figure 1). The resulting model was statistically significant (p < 0.0001) and explained 56.7% of the observed variance (Nagelkerke R2 = 0.567). The discriminative ability of the model was evaluated using receiver operating characteristic (ROC) curve analysis, yielding an area under the curve (AUC) of 0.917 [0.866–0.968], p < 0.0001, indicating excellent discrimination between patients with and without persistent cutaneous activity at six months (figure 2). The optimal probability threshold determined by Youden’s index was 0.105, corresponding to 100% sensitivity and 69% specificity. Abstract PO:03:088 Figure 1–2Conclusions The persistence of active cutaneous lesions in SLE was positively associated with higher SLE-DAS and R-CLASI activity index scores, positivity for anti-Ro/SS-A antibodies, combined anti-dsDNA/anti-Sm positivity, and photosensitivity. In contrast, higher SLEDAI-2K scores and decreased C4 complement levels were associated with a lower probability of persistent skin activity. The proposed logistic model may help identify patients at risk of refractory skin lesions.",
  "authors": [
    {
      "affiliations": [
        "V.A.Nasonova Research Institute of Rheumatology, Laboratory of Thromboinflammation, Moscow, Russia"
      ],
      "name": "Anastasiia Shumilova"
    },
    {
      "affiliations": [
        "V.A.Nasonova Research Institute of Rheumatology, Laboratory of Thromboinflammation, Moscow, Russia"
      ],
      "name": "Kamila Nurbaeva"
    },
    {
      "affiliations": [
        "V.A.Nasonova Research Institute of Rheumatology, Laboratory of Thromboinflammation, Moscow, Russia"
      ],
      "name": "Polina Sholkina"
    },
    {
      "affiliations": [
        "V.A.Nasonova Research Institute of Rheumatology, Laboratory of Thromboinflammation, Moscow, Russia",
        "Russian Medical Academy of Continuing Professional Education, Department of Rheumatology, Moscow, Russia"
      ],
      "name": "Tatiana Reshetnyak"
    }
  ],
  "title": "PO:03:088 Risk factors for persistence of cutaneous involvement in systemic lupus erythematosus",
  "uid": "8af144b3-a3c3-5ec6-bd93-cf6b0959f9f2"
}