A HISTORY OF SYSTEMIC LUPUS ERYTHEMATOSUS

DATE	DESCRIPTION
400 B.C.	Hippocrates writes about red ulcerating skin lesions which may or may not be connected with Lupus.
About 1200 A.D.	The term Lupus is used for the first time to describe red ulcerations on the face. The word Lupus literally means wolf and there are two theories as to why it was used.
	(1) The most common theory is that the skin rash, like a wolf, seemed to eat away the skin and destroy it. The rash, therefore, was said to resemble skin which had actually been bitten by a wolf; and
	(2) The frightening appearance of some Lupus sufferers put people in mind of werewolves. These were seen as human who had magical power to transform themselves into animals. The rash therefore, was said to make people’s faces resemble the face of a wolf and in the superstitious middle ages, that meant werewolves.
About 1800 A.D.	Dr. Willan, a British Dermatologist, includes Lupus in his classification of skin diseases. His description of Lupus emphasised the destructive nature of the disease and the lack of any treatment. At this time he was probably describing tuberculosis of the skin which is still known as Lupus Vulgaris rather than Lupus Erythematosus. Later in the 19th century, Cazenare, a student of French Dermatologist Blett, introduces the term Lupus Erythematosus and confirms that this is distinct from other ulcerating skin.
1875	Kaposi, a Viennese physician, recognises that Lupus Erythematosus can produce dangerous constitutional symptoms as well as skin rashes. He is acknowledged to be the first person to describe Systemic Lupus Erythematosus and also the first to describe the butterfly rash on the Lupus sufferer’s face.
1885-1903/4	Sir William Osler, in a series of papers, expands the concept of SLE and describes heart, lung, joint, brain, kidney and stomach symptoms. He also recognises that some cases of SLE occur without skin involvement.
1920s and 1930s	Pathologists working at Mt. Sinai Hospital in New York describe a number of symptoms unique to SLE e.g. heart involvement known as Libman - Sacko endocarditis, a kidney lesion known as the wire loop and the hemotoxylin body. Also the term collagen disease is used by Dr Klemperer for the first time.
1922	The false positive test for syphilis is recognised as a reasonably common finding in SLE. (It is known that about 30% of SLE patients have a false positive Wasserman Test - this does not mean these people have venereal disease.)
1948	The LE phenomenon is refined by Dr. Hargraves at the Mayo Clinic and quickly becomes the basis for diagnosing SLE. This cell is essentially a white blood cell which has engulfed the nucleus of another cell. SLE can now be recognised in milder and milder forms and the LE cell discovery is the first clear sign that SLE could be an autoimmune disease.
1950s	Florescent tests to detect antibodies against the nucleus of cells are developed. Referred to as anti-nuclear antibody tests (ANA), 95% of SLE patients are known to be positive. Corticosteroids are used for the first time to control symptoms of SLE.
1959	At Otago Medical School the NZ Brown X NZ White hybrid mouse is discovered to develop a lethal kidney disease closely resembling Lupus Nephritis - the kidney disease which some people with SLE develop. This mouse has since been studied in laboratories all around the world. Other mice which develop Lupus-like diseases have also been bred, particularly in the United States. These mice have aided research tremendously.
1960s	The prognosis for Lupus sufferers improves dramatically as diagnosis improves, drugs are used more sensitively and public awareness begins to develop.