The Systemic Lupus Activity Measure (SLAM) is a system proposed by rheumato
logists to measure disease activity in their patients with systemic lupus e
rythematosus (LE), It involves scoring a group of clinical symptoms and lab
oratory findings, the maximum possible score being 84. In systemic LE, the
mid-point is between 9 and 12, We applied SLAM to 176 patients with cutaneo
us LE. Ninety-seven had localized discoid LE (L-DLE), 59 had disseminated d
iscoid LE (D-DLE) and 20 had subacute cutaneous LE (SCLE). Eighty-five pati
ents had low activity disease (0-4 points), 72 mildly active disease (5-9 p
oints), 15 moderately active disease (10-14 points) and only four had very
active disease (greater than or equal to 15 points), The most frequent lesi
ons in patients who scored more than 10 points were photosensitivity, cicat
ricial alopecia, Raynaud's phenomenon and oral ulcers, Fifty patients were
followed up for more than 5 years (mean follow-up 9 years), Nine of these h
ad an increased SLAM score. Seven had L-DLE, one D-DLE and one SCLE, Seven
of the 50 patients had photosensitivity, five cicatricial alopecia, five no
n-cicatricial alopecia, two Raynaud's phenomenon and two oral ulcers, Three
patients who started with L-DLE evolved to D-DLE. The SLAM system is usefu
l in the monitoring of disease activity in patients with cutaneous LE. Over
time, even L-DLE patients may develop active disease. Photosensitivity, al
opecia, oral ulcers and Raynaud's phenomenon seem to herald a worse prognos
is.