Topical Treatments for Cutaneous Lupus

A note on diagnosing CLE The American College of Rheumatology (ACR) created an eleven-criteria tool for diagnosing lupus that includes clinical and lab. For a doctor to settle on a diagnosis of systemic lupus, at least 4 of the 11 criteria must be met. Of the eleven criteria, four deal with symptoms of the skin. They are: malar rash (butterfly rash) discoid lesions mucosal ulcers photosensitivity This overlap between the ACR systemic lupus guidelines and the cutaneous lupus symptoms have caused some researchers to question the prevalence of each disease. The European Society of CLE analyzed their multi-center dataset in 2012 exploring the challenges of diagnosing these diseases. Of lupus patients with 4 or more ACR criteria, 48% of patients had CLE, but not systemic lupus. It is not just researchers that are noticing the potential issues with the criteria. As a result, the Systemic Lupus International Collaborating Clinics Classification Criteria (SLICC) has been developed and is undergoing further comparative testing. For this guideline, there were 17 symptom criteria identified and a diagnosis of systemic lupus requires a clinical criterion and an immunologic one (or lupus nephritis).

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