Background Previous studies demonstrated an increased prevalence of human papillomavirus (HPV) related CW in patients with SLE.1 Problems associated with previous published series include the fact that sample sizes were small for both SLE patients and controls; moreover, the reported prevalence was not adjusted for immunosuppressive agents.
Objectives To evaluate factors associated with skin CW in patients with RA and SLE, and to determine whether SLE itself is an independent risk factor for CW.
Methods We included 670 patients in consecutive selection in this cross sectional study (550 with RA and 120 with SLE). All patients were evaluated by a dermatologist and two rheumatologists; patients with CW were selected as cases (63) and the other 607 patients were selected as controls. A structured questionnaire was administered to the subjects to ascertain the possible risk factors associated with CW. Parametric statistics were performed; categorical measurements were compared using X2 or exact Fisher’s test. Logistic regression was used to adjust for potential confounding variables.
Results The prevalence of CW was increased 2.8-fold in SLE patients (20%) compared with RA (7.1%). When comparing cases (patients with common warts=63) with controls (607), univariate analysis (Table 1) showed statistically significant differences for age, having SLE, and treatment with mycophenolate mofetil (MMF). When all of the potential risk factors identified using univariate analysis (age, having SLE, and MMF) were put into a multivariate model, independent risk factors for CW were having SLE (odds ratio: 2.16, 95% confidence interval: 1.04-4.48) and MMF therapy (odds ratio: 2.91, 95% confidence interval: 1.18-7.14).
Conclusions CW were more common in patients with SLE. MMF is an independent risk factor to the development of CW. The relationship of MMF and HPV gynecological infection should be studied because its association with cancer. Our findings may have an implication for the selection of SLE therapy.
Korkmaz C, Urer SM. Cutaneous warts in patients with lupus erythematosus. Rheumatol Int 2004;24:137-40.
Disclosure of Interest None Declared
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