Table 3.
Clinical and Immunologic Criteria Used in the SLICC Classification Criteria.
| Clinical Criteria |
|---|
| 1. Acute cutaneous lupus |
| including lupus malar rash (do not count if malar discoid) |
| bullous lupus |
| toxic epidermal necrolysis variant of SLE |
| maculopapular lupus rash |
| photosensitive lupus rash |
| in the absence of dermatomyositis |
| or subacute cutaneous lupus |
| (nonindurated psoriaform and/or annular polycyclic lesions that resolve without scarring, although occasionally with postinflammatory dyspigmentation or telangiectasias) |
| 2. Chronic cutaneous lupus |
| including classical discoid rash |
| localized (above the neck) |
| generalized (above and below the neck) |
| hypertrophic (verrucous) lupus |
| lupus panniculitis (profundus) |
| mucosal lupus |
| lupus erythematosus tumidus |
| chillblains lupus |
| discoid lupus/lichen planus overlap |
| 3. Oral ulcers: palate |
| buccal |
| tongue |
| or nasal ulcers |
| in the absence of other causes, such as vasculitis, Behcets, infection (herpes), inflammatory bowel disease, reactive arthritis, and acidic foods |
| 4. Nonscarring alopecia (diffuse thinning or hair fragility with visible broken hairs) |
| in the absence of other causes such as alopecia areata, drugs, iron deficiency and androgenic alopecia |
| 5. Synovitis involving two or more joints, characterized by swelling or effusion OR tenderness in 2 or more joints and thirty minutes or more of morning stiffness. |
| 6. Serositis |
| typical pleurisy for more than 1 day |
| or pleural effusions |
| or pleural rub |
| typical pericardial pain (pain with recumbency improved by sitting forward) for more than 1 day |
| or pericardial effusion |
| or pericardial rub |
| or pericarditis by EKG |
| in the absence of other causes, such as infection, uremia, and Dressler's pericarditis |
| 7. Renal |
| Urine protein/creatinine (or 24 hr urine protein) representing 500 mg of protein/24 hr |
| or |
| Red blood cell casts |
| 8. Neurologic |
| seizures |
| psychosis |
| mononeuritis multiplex |
| in the absence of other known causes such as primary vasculitis |
| myelitis |
| peripheral or cranial neuropathy |
| in the absence of other known causes such as primary vasculitis, infection, and diabetes mellitus |
| acute confusional state |
| in the absence of other causes, including toxic-metabolic, uremia, drugs |
| 9. Hemolytic anemia |
| 10. Leukopenia (< 4000/mm3 at least once) |
| in the absence of other known causes such as Felty's, drugs, and portal hypertension |
| OR |
| Lymphopenia (< 1000/mm3 at least once) |
| in the absence of other known causes such as corticosteroids, drugs and infection |
| 11. Thrombocytopenia (<100,000/mm3) at least once |
| in the absence of other known causes such as drugs, portal hypertension, and TTP |
| Immunological Criteria |
|---|
| 1. ANA above laboratory reference range |
| 2. Anti-dsDNA above laboratory reference range, except ELISA: twice above laboratory |
| reference range |
| 3. Anti-Sm |
| 4. Antiphospholipid antibody: any of the following |
| lupus anticoagulant |
| false-positive RPR |
| medium or high titer anticardiolipin (IgA, IgG or IgM) |
| anti-β2 glycoprotein I (IgA, IgG or IgM) |
| 5. Low complement |
| low C3 |
| low C4 |
| low CH50 |
| 6. Direct Coombs test in the absence of hemolytic anemia |
Criteria are cumulative and need not be present concurrently.