Association of truncal involvement in lupus erythematosus panniculitis patients with calcinosis cutis: A retrospective cohort study

BackgroundLupus erythematosus panniculitis (LEP) is a rare variant of cutaneous lupus erythematosus that typically presents as indurated nodules or plaques. Calcinosis cutis (CC) is a potential complication of this disease with limited treatment modalities and significant quality of life complications. The rate and risk factors of CC in LEP are not well understood. Thus, we conducted a retrospective cohort study on patients diagnosed with LEP.ObjectiveTo quantify the rate of CC and to identify the risk factors associated with its development in LEP.MethodsThis retrospective cohort study analyzed data from 27 LEP patients recruited in outpatient dermatology clinics at University of Texas Southwestern Medical Center and Parkland Health from January 2009 to December 2024. The primary outcome measure was CC development based on clinical diagnosis from a dermatologist, biopsy, or radiographic imaging. Data collected included demographics, smoking history, disease duration, medications, and lesion location. Predictor variables associated with CC development were analyzed either by Mann-Whitney U or Fisher's exact tests.Results10/27 (37%) LEP patients had CC during the evaluation period. LEP patients with CC had a higher rate of truncal involvement (9/10 (90%) versus 7/17 (41.2%); <i>p</i> = .02) and a lower rate of head & neck involvement (3/10 (30%) versus 13/17 (76.5%); <i>p</i> = .04) of their LEP lesions compared to those without CC.LimitationsThis study is limited by its single-center design, retrospective nature, and small sample size.ConclusionsThis cohort of LEP patients had over a third developing CC. LEP lesion location significantly differed in those who developed CC compared with those who did not. CC is a common complication of LEP that requires close monitoring by clinicians. Prospective multicenter studies are needed to confirm these findings and better understand the predictive factors for the development of CC in LEP patients.