Gaps in Skincare Knowledge, Sun Protection Practice Exist Among Patients With Lupus

This content was produced independently by The American Journal of Managed Care^® and is not endorsed by the American Academy of Dermatology.

A poster presented at the 2024 American Academy of Dermatology Annual Meeting showed gaps in skincare knowledge and sun protection practice among patients with lupus.

According to the poster, cutaneous lupus can manifest in the skin with acute, subacute, and chronic eruptions, which can be triggered and/or exacerbated by UV exposure. Because of this, in conjunction with topical and/or systemic therapies, the researchers noted that adherence to UV-protective behaviors is important in preventing and managing cutaneous lupus flares. However, past studies have found photoprotective knowledge disparities across skin type and race.

Photoprotection management of lupus is unaffordable for some patients, which may impact sunscreen application frequency. | Image Credit: lesterman - stock.adobe.com

Consequently, the researchers conducted a survey-based study that investigated the photoprotection knowledge, skincare management needs, and educational gaps of patients with lupus. Their objectives were to evaluate the photoprotection knowledge, habits, and confidence levels in patients with lupus; investigate their educational and medical skincare information sources; and assess potential structural and accessibility barriers faced in disease-related skin management.

To do so, the researchers developed an anonymous 41-item questionnaire, which they distributed via RedCap. Recruitment occurred through the Northwestern Medicine Enterprise Data Warehouse, ResearchMatch (a national patient registry), and lupus community groups and organizations. Eligible patients included those 18 years or older with a lupus diagnosis; participants self-reported race and ethnicity.

Of the 129 initiated questionnaires, 115 were completed and met the eligibility criteria. Most patients were non-Hispanic White (65%) with an annual household income between $100,000 and $199,999 (24%). Additionally, 80 patients (70%) had ongoing lupus-related skincare concerns.

In terms of knowledge, most patients received skincare information from dermatologists (49%) or rheumatologists (40%), with no statistically significant differences between the groups (P = .38). Also, the researchers explained that patients with self-identified Fitzpatrick skin tones (FST) 3 to 4 or FST 5 to 6 had lower photoprotection knowledge scores (P = .002 and P = .006, respectively) than participants with FST 1 or 2.

Additionally, the researchers noted that patients have received various recommendations from their medical providers on how to manage their skin-related lupus, the most common being to apply sunscreen (90%), wear sun-protective clothing (73%), and wear a wide-brimmed hat (65%). However, most of the study population (38%) only feel fairly confident in their knowledge about taking care of their skin.

Of the 115 respondents, 38 (33%) felt that skincare products recommended for lupus are unaffordable. More specifically, the study population most frequently identified sun-protective clothing (40%), sunscreen (34%), and medications (26%) as unaffordable. Similarly, 17 (15%) endorsed that the cost of sunscreen plays a role in how frequently they apply it. Lastly, 42 (37%) considered sun protection to be difficult.

The researchers acknowledged their study’s limitations, one being that the generalizability of their findings is limited by the small sample size and participant demographics; participants were predominantly from the Midwest, self-reported non-Hispanic White, and had high annual household income levels. However, they suggested ways that their findings can be applied in practice.

“Gaps in knowledge and sunscreen use highlight a need for greater education of lupus patients, particularly in communities of color,” the authors concluded. “Dermatologists and rheumatologists care for a substantial portion of patients with lupus and share a responsibility to educate on photoprotection.”

Reference

Roldan C, Patel R, Kundu R, Shastry J. Survey-based assessment of skin care knowledge and accessibility barriers in lupus. Presented at American Academy of Dermatology Annual Meeting; March 8-12, 2024; San Diego, CA. Poster 52298.