Elman et al developed a model for the diagnosis of discoid lupus erythematosus (DLE). The authors are from multiple institutions in the United States, Japan, South Korea, and Poland.
Parameters:
(1) atrophic scarring
(2) location in the conchal bowl (depression in the external ear leading to the external auditory meatus)
(3) preference for the head and neck
(4) dyspigmentation
(5) follicular hyperkeratosis and plugging
(6) erythematous to violaceous color
|
Parameter
|
Finding
|
Points
|
|
atropic scarring
|
absent
|
0
|
|
|
present
|
3
|
|
location in the conchal bowl
|
absent
|
0
|
|
|
present
|
2
|
|
preference for the head and neck
|
absent
|
0
|
|
|
present
|
2
|
|
dyspigmentation
|
absent
|
0
|
|
|
present
|
1
|
|
follicular hyperkeratosis and plugging
|
absent
|
0
|
|
|
present
|
1
|
|
erythematous to violaceous color
|
absent
|
0
|
|
|
present
|
1
|
total score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: 0
• maximum score: 10
Performance:
• A score >= 5 had a Youden index of 0.60 (sensitivity 0.84, specificity 0.76).
• A score >= 6 had a Youden index of 0.64 (sensitivity 0.80, specificity 0.84).
• A score >= 7 had a Youden index of 0.67 (sensitivity of 0.74, specificity 0.93).
• The area under the ROC curve is 0.91.
Other findings that may be present:
(1) scarring alopecia
(2) interface dermatitis (histology)
(3) perivascular and/or periappendageal lymphohistiocytic infiltrate (histology)
(4) basement membrane thickening (histology)
(5) mucin deposition (histology)
