History of systemic lupus erythematosus

The first description of cutaneous ulcerations consistent with systemic lupus erythematosus (SLE) has been attributed to Hippocrates. The term lupus first appeared in English literature in the tenth century. Until the nineteenth century, however, this term was used to describe different conditions. Osler first recognized that organ involvement may occur with or without skin involvement. With the discovery of LE cells and autoantibodies, the use of lupus murine models, and the recognition of familial aggregation and the importance of genetic factors, the pathogenesis of SLE started to be unravelled and allowed the definition of classification criteria. In parallel, the discovery of cortisone, the use of immunosuppressive drugs and antimalarials, the control of hypertension, and the availability of renal replacement therapy improved the prognosis of SLE from a 4-year survival of 51% to a 5-year survival >90%. Advances in genetics and targeted therapies will lead to better intermediate and long-term outcomes.