The mnemonic tool "I'M DAMN SHARP" is helpful in remembering all of the features of lupus. I stands for immunoglobulins present. M stands for malar rash. D represents discoid rash, A for antinuclear antibodies, M for mucositis, and N for neurological disorders, making DAMN. SHARP is made up by S for serositis, H for hematologic disorders, A representing arthritis, R standing for renal disorders and P for photosensitivity.
The presence of anti-dsDNA or anti-Smith or antiphospholipid antibodies is highly suggestive of SLE. Anti-dsDNA and anti-Smith antibodies are more specific for SLE than antinuclear (ANA) antibodies and their presence alone is virtually diagnostic.
This is the classic facial butterfly rash that exists in SLE. It involves the malar eminences and the bridge of the nose. This erythematous rash can be flat or raised and the nasolabial folds are spared unlike in the rash of rosacea.
Raised erythematous lesion on the face with scaling and scarring. The singer Seal’s facial scarring is due to discoid rash.
Antinuclear antibody (ANA) is abnormally elevated in SLE and is a highly sensitive, although nonspecific, marker.
Painless oral ulcers can be present.
Seizures or psychosis not due to other known causes can be present.
Pleuritis or pericarditis can be present.
Hemolytic anemia or leukopenia or lymphopenia or thrombocytopenia can be present.
Non-deforming arthritis affecting two or more peripheral joints. It affects MCP and PIP joints as in rheumatoid arthritis (RA) but unlike RA it is non-deforming and nonerosive.
Persistent proteinuria >0.5 gm/dL or >3 if quantitation not performed or cellular casts.
Rash resulting from exposure to sunlight.
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