This study aimed to categorise self-reported foot complaints in people with systemic lupus erythematosus (SLE) and foot symptoms.
The authors developed, tested and validated a self-reported questionnaire to identify, from a patient’s perspective, the nature and extent of complaints affecting the feet in SLE.
The questionnaire was posted to 406 people with SLE attending adult rheumatology clinics across three district health boards in Auckland, New Zealand.
The three possible independent groups of foot pain, skin disorders and vascular insufficiency were found to sufficiently describe the heterogeneous variation in foot symptoms reported.
Factor analysis for the foot pain category demonstrated a high positive loading for the inter-correlation of foot pain in the past month, current foot pain, intermittent claudication, numbness, loss of balance, swelling, foot joint pain, arch pain and tendon pain.
Skin disorders demonstrated a very high positive loading for three factors: skin rash, blistering skin rash and foot ulceration.
Neurological complaints (numbness and balance issues) also correlated strongly with other aspects of foot pain.
Vascular disease is a common finding in SLE and peripheral vascular disease in SLE is not always associated with the traditional risk factors, which further complicates categorisation.
In vascular insufficiency a high positive loading was noted for cold feet, chilblains and Raynaud’s phenomenon.
The relationships between heterogeneous foot complaints reported by the authors further supports the previously identified need for a targeted multidisciplinary (MDT) approach to the care of many patients with SLE.
This study was one of the first to consider categorisation of foot complaints in SLE.
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