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Like many rheumatological diseases, systemic lupus erythematosus (SLE) is difficult to diagnose owing to the constellation of findings required. I offer a mnemonic that contains the 11 categories used by the American College of Rheumatology,1from which four or more must be present to diagnose SLE: A RASH POINts MD.Arthritis Renal disease (proteinuria, cellular casts) ANA (positive antinuclear antibody) Serositis (pleurisy or pericarditis) H aematological disorders (haemolytic anaemia or leucopenia or lymphopenia or thrombocytopenia) Photosensitivity Oral ulcers I mmunological disorder (positive LE cell, anti-DNA, anti-Sm, false positive serological test for syphilis) N eurological disorders (seizures or psychosis, in the absence of other causes) Malar rash Discoid rash
Because the malar rash is the most easily recalled finding, this mnemonic uses that word and an accompanying message that it “points an MD to a possible diagnosis.”
Readers may find this useful in teaching students and residents to remember the many elements of this complex condition.
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