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Seasonal Variation in Daily Ratings of Pain and Rash of a Lupus Patient

Faculty Supervisor:
Dwight Krehbiel
Year of Project Completion:
Sarah Buller


Lupus erythematosus is an autoimmune disease, affecting over one million Americans. Lupus patients commonly report experiencing increased pain with various weather patterns and barometric pressure fluctuations. Journaling or charting such experiences is thought help a patient exercise some control over a seemingly unmanageable condition. This perspective inspired the data collection that gave rise to the current study, a case-study of an eighteen-year lupus sufferer who charted lupus-associated pain, rash presence, and barometric pressure for sixteen years. The goal of the present study was to describe and explain the patterns of pain and rash ratings charted by this patient. Analysis was conducted on eight years of charting (2000-2007). Hand-drawn charts were digitized using Engauge digitizing software. Hierarchical linear modeling (HLM) was used to examine relationships among pain, barometric pressure, season, and rash with years treated as individuals. Though statistical power was limited by the number of available years, patterns for several variables were noteworthy. Rash intensity was a significant predictor of pain (p = 0.024). While both rash intensity and pain varied across seasons, these variables showed somewhat different patterns over time. Mean pain ratings were highest in summer and lowest in autumn, while mean rash intensity ratings were highest in spring and lowest in autumn. Barometric pressure may partially account for some of the seasonal effects on pain and rash; however, it was not a significant predictor of either in HLM analyses. These findings offer insight to the variable experiences of a lupus sufferer. Patient intuitions and therapeutic charting have led to the discovery of striking pain patterns. Further research is underway to investigate the nature of these seasonal patterns and to determine if daily variability in barometric pressure will account for them.

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