Table 1

SLE criteria throughout the years with cutaneous features1 2

CriteriaCriteria itemsAlopecia as a criterion
1971 ACR6 cutaneous items (malar rash, discoid rash*, Raynaud’s phenomenon, alopecia, photosensitivity, oral/nasopharyngeal ulcers).Rapid loss of a large amount of scalp hair, by patient’s history or physician’s observation.†
1982 ACR4 cutaneous items (malar rash, discoid rash*, photosensitivity, oral ulcers).Criteria do not include alopecia as an item.
1997 ACR4 cutaneous items (malar rash, discoid rash*, photosensitivity, oral ulcers).Criteria do not include alopecia as an item.
2012 SLICC4 cutaneous items (acute cutaneous lupus erythematosus, subacute cutaneous lupus erythematosus*, oral ulcers, non-scarring alopecia).Diffuse thinning or hair fragility with visible broken hairs in the absence of other causes such as alopecia areata, drugs, iron deficiency and androgenetic alopecia.†
  • *Can also present clinically as alopecia.

  • †Definition does not require histopathological/immunopathological confirmation.

  • ACR, American College of Rheumatology; SLICC, Systemic Lupus International Collaborating Clinics.