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J Am Acad Dermatol. 2016 May;74(5):862-9. doi: 10.1016/j.jaad.2015.12.029. Epub 2016 Feb 18.

Using the American College of Rheumatology (ACR) and Systemic Lupus International Collaborating Clinics (SLICC) criteria to determine the diagnosis of systemic lupus erythematosus (SLE) in patients with subacute cutaneous lupus erythematosus (SCLE).

Author information

1
Corporal Michael J. Crescenz Philadelphia Department of Veterans Affairs Medical Center, Philadelphia, Pennsylvania; Department of Dermatology, University of Pennsylvania, Philadelphia, Pennsylvania.
2
Biostatistics and Epidemiology at the Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
3
Department of Dermatology, University of Pennsylvania, Philadelphia, Pennsylvania.
4
Corporal Michael J. Crescenz Philadelphia Department of Veterans Affairs Medical Center, Philadelphia, Pennsylvania; Department of Dermatology, University of Pennsylvania, Philadelphia, Pennsylvania. Electronic address: werth@mail.med.upenn.edu.

Abstract

BACKGROUND:

Approximately 50% of patients with subacute cutaneous lupus erythematosus (SCLE) meet criteria for systemic lupus erythematosus (SLE). The Systemic Lupus International Collaborating Clinics (SLICC) developed new SLE criteria to improve the American College of Rheumatology (ACR) criteria but the SLICC criteria have not been evaluated in patients with SCLE.

OBJECTIVE:

We sought to determine how patients with SCLE/SLE meet the ACR and SLICC criteria to compare the 2 sets of criteria.

METHODS:

This was a retrospective analysis of 107 patients with SCLE enrolled in a database at the University of Pennsylvania.

RESULTS:

Patients with SCLE/SLE were more likely than those with only SCLE to have oral ulcers, positive anti-double-stranded DNA antibodies, and positive antinuclear antibody test findings using both sets of criteria. Patients with SCLE/SLE were also more likely to have low complement using the SLICC criteria. There was a statistically insignificant increase in individuals meeting the SLICC criteria.

LIMITATIONS:

Not all patients received comprehensive laboratory testing.

CONCLUSIONS:

Most patients with SCLE who formally meet criteria for SLE do so based on the laboratory and mucocutaneous criteria. Neither the ACR nor SLICC criteria distinguish patients with SCLE and major internal disease from patients with SCLE without major internal disease.

KEYWORDS:

American College of Rheumatology; Systemic Lupus International Collaborating Clinics; classification criteria; cutaneous lupus erythematosus; subacute cutaneous lupus erythematosus; systemic lupus erythematosus

PMID:
26897388
PMCID:
PMC4879000
DOI:
10.1016/j.jaad.2015.12.029
[Indexed for MEDLINE]
Free PMC Article

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