Dermatology Position Paper on the Revision of the 1982 ACR Criteria for Systemic Lupus Erythematosus

In 2004, the authors of the position paper on the 1982 American College of Rheumatology (ACR) criteria for systemic lupus erythematosus (SLE) highlighted the need for revision of these criteria, particularly to address the overemphasis on skin symptoms which could lead to misclassification of patients with other skin diseases. They recommended the involvement of dermatologists in patient recruitment for studies aimed at revising the criteria and suggested that future studies should include diverse international patient populations, current evaluations, and control groups with at least 73 patients each to ensure specificity. The paper did not propose specific changes but emphasized the need for criteria that reflect modern diagnostics and are relevant to dermatological differential diagnosis. The authors also discussed the importance of distinguishing between different types of lupus and other diseases, the potential inclusion of alopecia and SCLE lesions in the criteria, and the need for histological proof for cutaneous lesions. They suggested that criteria should be weighted and possibly divided into major and minor categories, with major criteria including LE-specific factors and minor criteria being clinically unspecific.