Bonilla-Martinez et al developed the Cutaneous LE Disease Area and Severity Index (CLASI) to evaluate patients with cutaneous lupus erythematosus. The total damage score is a measure of disease damage. The authors are from the University of Pennsylvania and the Philadelphia Veterans Affairs Hospital.
Parameters for the damage score:
(1) dyspigmentation in 13 anatomical locations
(2) scarring, atrophy or panniculitis in 12 anatomical locations (excludes the scalp, which is handled separately)
(3) duration of dyspigmentation in months
(4) scarring of the scalp in the 4 scalp quadrants (dividing lines = sagittal midline and coronal at the external acoustic meatus)
Anatomical locations:
(1) scalp
(2) ears
(3) nose and malar region
(4) rest of face
(5) V area of chest and neck in front
(6) posterior neck and shoulders
(7) chest
(8) abdomen
(9) back and buttocks
(10) arms
(11) hands
(12) legs
(13) feet
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Dyspigmentation
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Points
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|
none
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0
|
|
present
|
1
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subscore for dyspigmentation =
= SUM(points for dyspigmentation in each anatomic location)
If the duration of the dyspigmentation after active lesions have resolved is >= 12 months, then the dyspigmentation score is doubled, else not:
subscore for dyspigmentation adjusted for duration =
= (subscore for dyspigmentation) * (2 if duration >= 12 months, 1 if < 12 months)
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Scarring, Atrophy or Panniculitis
|
Points
|
|
none
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0
|
|
scarring
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1
|
|
severe atrophic scarring
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2
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panniculitis
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2
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subscore for scarring/atrophy/panniculitis =
= SUM(points for each anatomic location excluding scalp)
|
Scarring of Scalp
|
Points
|
|
none
|
0
|
|
1 quadrant involved
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3
|
|
2 quadrants
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4
|
|
3 quadrants
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5
|
|
4 quadrants
|
6
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total activity score =
= (points for dyspigmentation adjusted for duration) + (points for scarring, atrophy, panniculitis) + (points for scarring of the scalp)
Interpretation:
• minimum total damage score: 0
• maximum total damage score: 56
• The higher the score the greater the disease damage.
