To the Editor.—
The preliminary criteria for the classification of systemic lupus erythematosus (LE) put out by the American Rheumatism Association (ARA) Committee on Therapeutics1 are of great importance for dermatologists and rheumatologists who are often presented with the question of whether a patient has systemic LE.As dermatologists with special interests in cutaneous LE, we are concerned that clinicians may have difficulty in carefully applying the cutaneous items (six out of 14 major manifestations) of the proposed criteria for systemic LE because of lack of clarity and specificity in the definitions. These deficiencies in the ARA preliminary criteria1 are the probable reasons for the substantial disparities between the incidences of the cutaneous features in two recently reported series of patients with systemic LE.2,3 The differences relate to the incidences of discoid LE, alopecia, photosensitivity, and oral or nasal ulcerations.We would specify our objections to these criteria as