Should we advise patients with lupus to quit smoking?

Please cite this article as: Pastushenko I, Martin-Gorgojo A. RF ¿Debemos aconsejar dejar de fumar a los pacientes con lupus?. Actas Dermosifiliogr. 2014;105:949--950. ∗ Corresponding author. E-mail address: [email protected] (I. Pastushenko). (CLE). Here we discuss the results of 2 recently published studies in which the influence of smoking on cutaneous manifestations of lupus erythematosus was investigated. Kuhn et al. conducted a cross-sectional multicenter study of 1002 patients from 14 European countries. They found that the data on smoking obtained by questionnaire by the European Society of Cutaneous Lupus Erythematosus (EUSCLE) correlated with the severity of CLE (Cutaneous Lupus Erythematosus Disease Area and Severity Index [CLASI]) and with the response to treatment with antimalarials. The authors found that the prevalence of smoking among patients with CLE (59.5%) was significantly higher than the estimated prevalence among the adult population in Europe (25%-30%). Moreover, 87.2% of smokers with CLE reported having started smoking before the appearance of disease symptoms, supporting the hypothesis that smoking may contribute to the induction of CLE. The CLASI score was also significantly higher in patients that smoked, indicating that smoking may exacerbate the cutaneous manifestations of the disease. Another important clinical finding was that the response rate to treatment with chloroquine/hydroxychloroquine was significantly lower in patients that smoked. Bourre-Tessier and coworkers conducted a prospective multicenter study of 1346 patients from 14 centers in Canada to evaluate the influence of smoking on cutaneous manifestations in patients with systemic lupus