HISTORY
The term “lupus erythemateaux” was first used by Cazenave in the mid-1800s1. Cazenave and others helped to articulate the difference between lupus erythematosus (LE) and lupus vulgaris, a clinical variant of cutaneous tuberculosis. Due in part to observations of Hutchinson, Osler, and Jadassohn, it was recognized that cutaneous lesions of LE may be associated with significant internal abnormalities, including arthritis, nephritis, serositis, cytopenias, and neurologic disease. In 1964 and during the following years, Dubois developed the concept of lupus as a spectrum of disease, ranging from isolated cutaneous lesions to life-threatening, multi-organ disease. Gilliam also developed the concept of a spectrum of cutaneous disease, and, in 1979, along with Sontheimer and Thomas, clearly separated and named the entity now known as subacute cutaneous lupus erythematosus (SCLE). The description was virtually identical to that of “ANA-negative” lupus, reported by Maddison, Provost, and Reichlin in 1981.
Important diagnostic advances included: discovery of the LE cell phenomenon by Hargraves, Richmond, and Morton in 1948; identification of ANA by Friou in 1957; description of the lupus band test by Burnham, Neblett, and Fine in 1963; and the association of specific clinical manifestations of lupus with specific autoantibodies by a variety of investigators. With regard to skin disease, the associations of anti-Ro (also known as anti-SSA) autoantibodies with neonatal lupus by Weston et al. in 1981 and with subacute cutaneous LE (SCLE) by Sontheimer et al. in 1982 are noteworthy milestones.
Antimalarial therapy in the form of quinine was used for cutaneous lupus by Payne in 1894. By the late 1950s, synthetic antimalarials had become a mainstay of therapy. Systemic corticosteroids and other immunosuppressive agents came into use during the mid-twentieth century.