1) MALAR RASH: Fixed erythema, flat or raised, over the malar eminencies, tending to spare the nasolabial folds.

2) DISCOID RASH: Erythematous raised patches with adherent keratotic scaling and follicular plugging; atrophic scarring may occur in older lesions.

3) PHOTOSENSITIVITY: Skin rash as a result of an unusual reaction to sunlight, by patient history or physician observation.

4) ORAL ULCERS: Oral or nasopharyngeal ulceration, usually painless, observed by a physician.

5) ARTHRITIS: Nonerosive arthritis involving two or more peripheral joints, characterized by tenderness, swelling, or effusion.

6) SEROSITIS: Manifests as pleuritis or pericarditis.

7) RENAL DISORDER: Manifests as proteinuria (more than 0.5 grams/day or 3+ on urinalysis) or cellular casts (red cell, hemoglobin, granular, tubular, or mixed).

8) NEUROLOGIC DISORDER: Seizures or psychosis are the most common manifestations.

9) HEMATOLOGIC DISORDER: Hemolytic anemia with reticulocytosis or leukopenia less than 4,000 cells/mm3 or lymphopenia less than 1,500 cells/mm3 or thrombocytopenia less than 100,000 cells/mm3.

10) IMMUNOLOGIC DISORDER: Positive LE cell preparation or anti-DNA antibody or anti-Sm antibody or false-positive syphilis serology (present for at least 6 months and confirmed by MHA-TP or FTA-ABS).

11) ANTINUCLEAR ANTIBODY: A positive test in the absence of medications known to cause drug-induced lupus.

Systemic lupus erythematous is a clinical diagnosis made when 4 of the above 11 criteria are present.