Cutaneous lupus concerns from the patient perspective: a qualitative study

Objective There is a need to identify concerns unique to patients with cutaneous lupus erythematosus (CLE), which may not be captured by current common-practice dermatological quality-of-life tools. This study formally characterises what bothers patients with CLE about their disease by conducting se...

Full description

Saved in:
Bibliographic Details
Main Authors: Victoria P Werth, Rui Feng, Daisy Yan, Sarah Ahmed, Srita Chakka, Danielle Zamalin, Rebecca Krain, Josef Concha, Joyce Okawa
Format: Article
Language:English
Published: BMJ Publishing Group 2021-05-01
Series:Lupus Science and Medicine
Online Access:https://lupus.bmj.com/content/8/1/e000444.full
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850191723177705472
author Victoria P Werth
Rui Feng
Daisy Yan
Sarah Ahmed
Srita Chakka
Danielle Zamalin
Rebecca Krain
Josef Concha
Joyce Okawa
author_facet Victoria P Werth
Rui Feng
Daisy Yan
Sarah Ahmed
Srita Chakka
Danielle Zamalin
Rebecca Krain
Josef Concha
Joyce Okawa
author_sort Victoria P Werth
collection DOAJ
description Objective There is a need to identify concerns unique to patients with cutaneous lupus erythematosus (CLE), which may not be captured by current common-practice dermatological quality-of-life tools. This study formally characterises what bothers patients with CLE about their disease by conducting semistructured, qualitative interviews.Methods Sixteen patients with CLE were interviewed about how their cutaneous findings impact their daily life. Each interview was transcribed, coded and categorised for recurrent themes. Current CLE activity and damage were also assessed by the Cutaneous Lupus Activity and Severity Index tool.Results Responses were categorised into six themes, including Fear of Disease Progression, Unwanted Attention, Self-Consciousness, Physical Signs/Symptoms, Emotional Symptoms and Functional Decline. The most commonly reported themes were Self-Consciousness, mentioned by 13 of 16 (81.3%) patients, Physical Symptoms, mentioned by 12 of 16 (75%), and then Fear of Disease Progression, by 11 of 16 (68.8%). Frequently mentioned physical signs/symptoms included erythema, itch, dyspigmentation, scar and alopecia. The physical signs/symptoms were categorised as activity signs/symptoms, damage signs and other. For activity signs, erythema was mentioned most frequently (5 of 16), then scale (2 of 16). For activity symptoms, itch was mentioned most frequently (6 of 16), then pain (5 of 16). For damage signs, dyspigmentation was mentioned most frequently (4 of 16), followed by scarring (3 of 16). Patients less than 60 years old were more likely to report emotional symptoms than older patients (p<0.05), but there was no significant variation in frequency of reported themes between race, sex or subtype of CLE.Conclusions These patient experiences and resultant themes elucidated by this study are worth noting in future standardised estimations of the quality of life of patients with CLE. Additionally, the concerns shown by these interviews are important topics for providers to discuss when evaluating patient disease progression.
format Article
id doaj-art-b85aad039eed43dfba0662db46712ebd
institution OA Journals
issn 2053-8790
language English
publishDate 2021-05-01
publisher BMJ Publishing Group
record_format Article
series Lupus Science and Medicine
spelling doaj-art-b85aad039eed43dfba0662db46712ebd2025-08-20T02:14:49ZengBMJ Publishing GroupLupus Science and Medicine2053-87902021-05-018110.1136/lupus-2020-000444Cutaneous lupus concerns from the patient perspective: a qualitative studyVictoria P Werth0Rui Feng1Daisy Yan2Sarah Ahmed3Srita Chakka4Danielle Zamalin5Rebecca Krain6Josef Concha7Joyce Okawa8Department of Dermatology, Corporal Michael J Crescenz VA Medical Center, Philadelphia, Pennsylvania, USA2University of Pennsylvania, Philadelphia, United States of AmericaDermatology, Corporal Michael J Crescenz VA Medical Center, Philadelphia, Pennsylvania, USANorthern Gynaecological Oncology Centre, Queen Elizabeth Hospital, Gateshead Health NHS Foundation Trust, Gateshead, UKDermatology, University of Pennsylvania, Philadelphia, Pennsylvania, USADermatology, Corporal Michael J Crescenz VA Medical Center, Philadelphia, Pennsylvania, USADermatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA1Dermatology, University of Pennsylvania, USADermatology, University of Pennsylvania, Philadelphia, Pennsylvania, USAObjective There is a need to identify concerns unique to patients with cutaneous lupus erythematosus (CLE), which may not be captured by current common-practice dermatological quality-of-life tools. This study formally characterises what bothers patients with CLE about their disease by conducting semistructured, qualitative interviews.Methods Sixteen patients with CLE were interviewed about how their cutaneous findings impact their daily life. Each interview was transcribed, coded and categorised for recurrent themes. Current CLE activity and damage were also assessed by the Cutaneous Lupus Activity and Severity Index tool.Results Responses were categorised into six themes, including Fear of Disease Progression, Unwanted Attention, Self-Consciousness, Physical Signs/Symptoms, Emotional Symptoms and Functional Decline. The most commonly reported themes were Self-Consciousness, mentioned by 13 of 16 (81.3%) patients, Physical Symptoms, mentioned by 12 of 16 (75%), and then Fear of Disease Progression, by 11 of 16 (68.8%). Frequently mentioned physical signs/symptoms included erythema, itch, dyspigmentation, scar and alopecia. The physical signs/symptoms were categorised as activity signs/symptoms, damage signs and other. For activity signs, erythema was mentioned most frequently (5 of 16), then scale (2 of 16). For activity symptoms, itch was mentioned most frequently (6 of 16), then pain (5 of 16). For damage signs, dyspigmentation was mentioned most frequently (4 of 16), followed by scarring (3 of 16). Patients less than 60 years old were more likely to report emotional symptoms than older patients (p<0.05), but there was no significant variation in frequency of reported themes between race, sex or subtype of CLE.Conclusions These patient experiences and resultant themes elucidated by this study are worth noting in future standardised estimations of the quality of life of patients with CLE. Additionally, the concerns shown by these interviews are important topics for providers to discuss when evaluating patient disease progression.https://lupus.bmj.com/content/8/1/e000444.full
spellingShingle Victoria P Werth
Rui Feng
Daisy Yan
Sarah Ahmed
Srita Chakka
Danielle Zamalin
Rebecca Krain
Josef Concha
Joyce Okawa
Cutaneous lupus concerns from the patient perspective: a qualitative study
Lupus Science and Medicine
title Cutaneous lupus concerns from the patient perspective: a qualitative study
title_full Cutaneous lupus concerns from the patient perspective: a qualitative study
title_fullStr Cutaneous lupus concerns from the patient perspective: a qualitative study
title_full_unstemmed Cutaneous lupus concerns from the patient perspective: a qualitative study
title_short Cutaneous lupus concerns from the patient perspective: a qualitative study
title_sort cutaneous lupus concerns from the patient perspective a qualitative study
url https://lupus.bmj.com/content/8/1/e000444.full
work_keys_str_mv AT victoriapwerth cutaneouslupusconcernsfromthepatientperspectiveaqualitativestudy
AT ruifeng cutaneouslupusconcernsfromthepatientperspectiveaqualitativestudy
AT daisyyan cutaneouslupusconcernsfromthepatientperspectiveaqualitativestudy
AT sarahahmed cutaneouslupusconcernsfromthepatientperspectiveaqualitativestudy
AT sritachakka cutaneouslupusconcernsfromthepatientperspectiveaqualitativestudy
AT daniellezamalin cutaneouslupusconcernsfromthepatientperspectiveaqualitativestudy
AT rebeccakrain cutaneouslupusconcernsfromthepatientperspectiveaqualitativestudy
AT josefconcha cutaneouslupusconcernsfromthepatientperspectiveaqualitativestudy
AT joyceokawa cutaneouslupusconcernsfromthepatientperspectiveaqualitativestudy