ARA and EADV criteria for classification of systemic lupus erythematosus in patients with cutaneous lupus erythematosus

A. Parodi, A. Rebora

Research output: Contribution to journalArticle

37 Citations (Scopus)

Abstract

Objective: To verify (1) how many patients with cutaneous lupus erythematosus (CLE) fulfill 4 or more American Rheumatism Association (ARA) and European Academy of Dermatology and Venereology (EADV) criteria for classification of systemic lupus erythematosus (SLE); (2) which criteria are mostly fulfilled; (3) the severity of the disease in patients fulfilling criteria; (4) how many patients with systemic involvement fail to fulfill 4 ARA and EADV criteria. Methods: We studied 207 patients with chronic and subacute CLE, classified according to ARA and EADV criteria. Results: Twenty-four patients with localized discoid (L-DLE; 21.8%), 22 with disseminated discoid (D-DLE 30.5%) and 7 with subacute CLE (SCLE; 28%) had 4 or more ARA criteria. With EADV criteria, these figures fell to 7 (6.4%), 7 (9.7%) and 6 (24%), respectively. Only 3 L-DLE (2.7%), 5 D-DLE (6.9%) and 3 SCLE cases (12%) defined as SLE by ARA criteria and 1, 3 and 3, respectively, by EADV criteria had a renal or neurological disorder, hemolytic anemia and/or thrombocytopenia, vasculitis or serositis. ARA criteria did not classify 7 patients with a similar visceral involvement, while EADV criteria failed in 11 patients. Conclusion: In our patients, ARA criteria showed a sensitivity of 88%, a specificity of 79%, a positive predictive value of 56% and a negative predictive value of 96%. EADV criteria showed a sensitivity of only 64%, but a specificity of 93%, a positive predictive value of 61% and a negative predictive value of 94%. ARA criteria should not be used in CLE patients as they are too sensitive, poorly specific and altogether misleading. EADV criteria are more specific, but less sensitive.

Original languageEnglish
Pages (from-to)217-220
Number of pages4
JournalDermatology
Volume194
Issue number3
Publication statusPublished - 1997

Fingerprint

Venereology
Cutaneous Lupus Erythematosus
Dermatology
Rheumatic Diseases
Systemic Lupus Erythematosus
Serositis
Discoid Lupus Erythematosus
Hemolytic Anemia
Vasculitis
Nervous System Diseases
Thrombocytopenia
Kidney

Keywords

  • ARA criteria
  • Cutaneous lupus erythematosus
  • Systemic lupus erythematosus

ASJC Scopus subject areas

  • Dermatology

Cite this

ARA and EADV criteria for classification of systemic lupus erythematosus in patients with cutaneous lupus erythematosus. / Parodi, A.; Rebora, A.

In: Dermatology, Vol. 194, No. 3, 1997, p. 217-220.

Research output: Contribution to journalArticle

@article{24aee2e3814b4e338fa8f586df64d7a0,
title = "ARA and EADV criteria for classification of systemic lupus erythematosus in patients with cutaneous lupus erythematosus",
abstract = "Objective: To verify (1) how many patients with cutaneous lupus erythematosus (CLE) fulfill 4 or more American Rheumatism Association (ARA) and European Academy of Dermatology and Venereology (EADV) criteria for classification of systemic lupus erythematosus (SLE); (2) which criteria are mostly fulfilled; (3) the severity of the disease in patients fulfilling criteria; (4) how many patients with systemic involvement fail to fulfill 4 ARA and EADV criteria. Methods: We studied 207 patients with chronic and subacute CLE, classified according to ARA and EADV criteria. Results: Twenty-four patients with localized discoid (L-DLE; 21.8{\%}), 22 with disseminated discoid (D-DLE 30.5{\%}) and 7 with subacute CLE (SCLE; 28{\%}) had 4 or more ARA criteria. With EADV criteria, these figures fell to 7 (6.4{\%}), 7 (9.7{\%}) and 6 (24{\%}), respectively. Only 3 L-DLE (2.7{\%}), 5 D-DLE (6.9{\%}) and 3 SCLE cases (12{\%}) defined as SLE by ARA criteria and 1, 3 and 3, respectively, by EADV criteria had a renal or neurological disorder, hemolytic anemia and/or thrombocytopenia, vasculitis or serositis. ARA criteria did not classify 7 patients with a similar visceral involvement, while EADV criteria failed in 11 patients. Conclusion: In our patients, ARA criteria showed a sensitivity of 88{\%}, a specificity of 79{\%}, a positive predictive value of 56{\%} and a negative predictive value of 96{\%}. EADV criteria showed a sensitivity of only 64{\%}, but a specificity of 93{\%}, a positive predictive value of 61{\%} and a negative predictive value of 94{\%}. ARA criteria should not be used in CLE patients as they are too sensitive, poorly specific and altogether misleading. EADV criteria are more specific, but less sensitive.",
keywords = "ARA criteria, Cutaneous lupus erythematosus, Systemic lupus erythematosus",
author = "A. Parodi and A. Rebora",
year = "1997",
language = "English",
volume = "194",
pages = "217--220",
journal = "Dermatology",
issn = "1018-8665",
publisher = "S. Karger AG",
number = "3",

}

TY - JOUR

T1 - ARA and EADV criteria for classification of systemic lupus erythematosus in patients with cutaneous lupus erythematosus

AU - Parodi, A.

AU - Rebora, A.

PY - 1997

Y1 - 1997

N2 - Objective: To verify (1) how many patients with cutaneous lupus erythematosus (CLE) fulfill 4 or more American Rheumatism Association (ARA) and European Academy of Dermatology and Venereology (EADV) criteria for classification of systemic lupus erythematosus (SLE); (2) which criteria are mostly fulfilled; (3) the severity of the disease in patients fulfilling criteria; (4) how many patients with systemic involvement fail to fulfill 4 ARA and EADV criteria. Methods: We studied 207 patients with chronic and subacute CLE, classified according to ARA and EADV criteria. Results: Twenty-four patients with localized discoid (L-DLE; 21.8%), 22 with disseminated discoid (D-DLE 30.5%) and 7 with subacute CLE (SCLE; 28%) had 4 or more ARA criteria. With EADV criteria, these figures fell to 7 (6.4%), 7 (9.7%) and 6 (24%), respectively. Only 3 L-DLE (2.7%), 5 D-DLE (6.9%) and 3 SCLE cases (12%) defined as SLE by ARA criteria and 1, 3 and 3, respectively, by EADV criteria had a renal or neurological disorder, hemolytic anemia and/or thrombocytopenia, vasculitis or serositis. ARA criteria did not classify 7 patients with a similar visceral involvement, while EADV criteria failed in 11 patients. Conclusion: In our patients, ARA criteria showed a sensitivity of 88%, a specificity of 79%, a positive predictive value of 56% and a negative predictive value of 96%. EADV criteria showed a sensitivity of only 64%, but a specificity of 93%, a positive predictive value of 61% and a negative predictive value of 94%. ARA criteria should not be used in CLE patients as they are too sensitive, poorly specific and altogether misleading. EADV criteria are more specific, but less sensitive.

AB - Objective: To verify (1) how many patients with cutaneous lupus erythematosus (CLE) fulfill 4 or more American Rheumatism Association (ARA) and European Academy of Dermatology and Venereology (EADV) criteria for classification of systemic lupus erythematosus (SLE); (2) which criteria are mostly fulfilled; (3) the severity of the disease in patients fulfilling criteria; (4) how many patients with systemic involvement fail to fulfill 4 ARA and EADV criteria. Methods: We studied 207 patients with chronic and subacute CLE, classified according to ARA and EADV criteria. Results: Twenty-four patients with localized discoid (L-DLE; 21.8%), 22 with disseminated discoid (D-DLE 30.5%) and 7 with subacute CLE (SCLE; 28%) had 4 or more ARA criteria. With EADV criteria, these figures fell to 7 (6.4%), 7 (9.7%) and 6 (24%), respectively. Only 3 L-DLE (2.7%), 5 D-DLE (6.9%) and 3 SCLE cases (12%) defined as SLE by ARA criteria and 1, 3 and 3, respectively, by EADV criteria had a renal or neurological disorder, hemolytic anemia and/or thrombocytopenia, vasculitis or serositis. ARA criteria did not classify 7 patients with a similar visceral involvement, while EADV criteria failed in 11 patients. Conclusion: In our patients, ARA criteria showed a sensitivity of 88%, a specificity of 79%, a positive predictive value of 56% and a negative predictive value of 96%. EADV criteria showed a sensitivity of only 64%, but a specificity of 93%, a positive predictive value of 61% and a negative predictive value of 94%. ARA criteria should not be used in CLE patients as they are too sensitive, poorly specific and altogether misleading. EADV criteria are more specific, but less sensitive.

KW - ARA criteria

KW - Cutaneous lupus erythematosus

KW - Systemic lupus erythematosus

UR - http://www.scopus.com/inward/record.url?scp=0030925861&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0030925861&partnerID=8YFLogxK

M3 - Article

C2 - 9187836

AN - SCOPUS:0030925861

VL - 194

SP - 217

EP - 220

JO - Dermatology

JF - Dermatology

SN - 1018-8665

IS - 3

ER -