Association of Short-Term Ultraviolet Radiation Exposure and Disease Severity in Juvenile Dermatomyositis: Results From the Childhood Arthritis and Rheumatology Research Alliance Legacy Registry

Jessica Neely; Craig S Long; Hugh Sturrock; Susan Kim; Childhood Arthritis and Rheumatology Research Alliance Registry Investigators

doi:10.1002/acr.23840

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Association of Short-Term Ultraviolet Radiation Exposure and Disease Severity in Juvenile Dermatomyositis: Results From the Childhood Arthritis and Rheumatology Research Alliance Legacy Registry

Journal article

Peer reviewed

Association of Short-Term Ultraviolet Radiation Exposure and Disease Severity in Juvenile Dermatomyositis: Results From the Childhood Arthritis and Rheumatology Research Alliance Legacy Registry

Jessica Neely, Craig S Long, Hugh Sturrock, Susan Kim and Childhood Arthritis and Rheumatology Research Alliance Registry Investigators

Arthritis care & research (2010), Vol.71(12), pp.1600-1605

12/2019

DOI: 10.1002/acr.23840

PMID: 30714338

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Abstract

Ultraviolet (UV) radiation is considered to be an important environmental factor in the clinical course of children with juvenile dermatomyositis (DM). We aimed to evaluate the association between UV radiation and severe disease outcomes in juvenile DM. This is a cross-sectional study of patients with juvenile DM enrolled in the US multicenter Childhood Arthritis and Rheumatology Research Alliance (CARRA) Legacy Registry from 2010 to 2015. The mean UV index (UVI) in the calendar month prior to symptom onset in each subject's zip code was calculated from daily satellite solar noon measurements. Multivariable logistic regression was used to model the relationship between the mean UVI and calcinosis as well as other outcomes of severe disease. Covariates included sex, race, age, time to diagnosis, disease duration, and latitude. In a multivariable model, there was no association between the mean UVI and calcinosis. African American race was associated with a 3-fold greater odds of calcinosis. However, there was a significant statistical interaction between race and mean UVI. Accounting for this interaction, the odds of calcinosis markedly decreased in African American subjects and steadily increased in non-African American subjects over a range of increasing the mean UVI. Higher mean UVI was associated with decreased odds of using biologics or nonmethotrexate disease-modifying antirheumatic drugs and skin ulceration. We described a novel association between UV radiation, calcinosis, and race in a large cohort of patients with juvenile DM. This study furthers our knowledge of the role of UV radiation in the clinical course of juvenile DM and highlights the complex interplay between genes and environment in the clinical phenotypes and development of calcinosis in children with juvenile DM.

Registries

Rheumatology

United States - epidemiology

Calcinosis - diagnosis

Prognosis

Follow-Up Studies

Humans

Dermatomyositis - ethnology

Child, Preschool

Male

Incidence

Calcinosis - etiology

Female

Retrospective Studies

Child

Skin - pathology

Severity of Illness Index

Calcinosis - ethnology

Cross-Sectional Studies

Risk Factors

Dermatomyositis - diagnosis

Disease Progression

Ultraviolet Rays - adverse effects

Environmental Exposure - adverse effects

Skin - radiation effects

Details

Title: Subtitle: Association of Short-Term Ultraviolet Radiation Exposure and Disease Severity in Juvenile Dermatomyositis: Results From the Childhood Arthritis and Rheumatology Research Alliance Legacy Registry
Creators: Jessica Neely - University of California, San Francisco
Craig S Long - National Oceanic and Atmospheric Administration, College Park, Maryland
Hugh Sturrock - University of California, San Francisco
Susan Kim - University of California, San Francisco
Childhood Arthritis and Rheumatology Research Alliance Registry Investigators
Contributors: Polly J Ferguson (Contributor) - University of Iowa, Stead Family Department of Pediatrics
Resource Type: Journal article
Publication Details: Arthritis care & research (2010), Vol.71(12), pp.1600-1605
DOI: 10.1002/acr.23840
PMID: 30714338
NLM abbreviation: Arthritis Care Res (Hoboken)
ISSN: 2151-464X
eISSN: 2151-4658
Publisher: United States
Grant note: A131657 / Childhood Arthritis & Rheumatology Research Alliance RC2 AR058934 / NIAMS NIH HHS
Language: English
Date published: 12/2019
Academic Unit: Stead Family Department of Pediatrics; Iowa Neuroscience Institute; Rheumatology, Allergy, and Immunology
Record Identifier: 9984070448602771

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