William Osler and development of the concept of systemic lupus erythematosus.

Abstract:

OBJECTIVE:This historical review summarizes the understanding of lupus erythematosus (LE) during the time of the career of William Osler and analyzes factors that may have retarded the clinical identification of this disease. METHODS:All of Osler's writings related to diseases that he defined as the "erythema group" were studied, in conjunction with relevant writings on Schönlein-Henoch purpura and erythema multiforme. RESULTS:Osler did not knowingly describe cases of LE, nor did he discuss the disease in general. He proposed that a primary skin disease, which in some cases has visceral manifestations, may develop as a purely visceral disease, using cases from his "erythema group" cohort as evidence. CONCLUSIONS:The reluctance into the 1940s to diagnose systemic LE was primarily a consequence of the erroneous belief that a skin eruption was required to establish the diagnosis. Osler's teaching the possible dissociation of visceral from cutaneous symptoms with regard to the erythema group was not analogized to LE. The interpretation that Osler had elucidated aspects of LE has developed since 1937 and attributes insights to Osler that his writings do not substantiate.

journal_name

Semin Arthritis Rheum

authors

Benedek TG

doi

10.1016/s0049-0172(97)80037-6

subject

Has Abstract

pub_date

1997-08-01 00:00:00

pages

48-56

issue

1

eissn

0049-0172

issn

1532-866X

pii

S0049-0172(97)80037-6

journal_volume

27

pub_type

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