Systemic lupus erythematosus (SLE as favored by the alphabet addicts, with whom I am in sympathy1) no longer is an oddity in clinical medicine. The apogee is not to feel secure in having recognized an example or two in clinical practice. Rather the race today is to suspect the malady at the earliest possible moment on the basis of one or more of a significant number of findings and, thereby, to inhibit the inevitable development of grave regressive changes. Systemic lupus erythematosus derives its name from the ravishing character of the morbid process in the late clinical stages (L. lupus wolf). The butterfly rash on the malar prominences (erythematosus) likewise may be a late manifestation. Frequently the disease runs the entire clinical course without this particular characteristic component.
The alterations that appear early in the disease, the first detectable feature of a morbid reaction, are commanding attention at the
J. H. T.. THE RED WOLF DISEASE. JAMA. 1960;173(15):1664–1665. doi:10.1001/jama.1960.03020330032008