Thomas Lupus: Introduction

 Lupus

(Color Atlas of Pediatric Dermatology Samuel Weinberg, 2008)

Historical and Contemporary Overview

            The history Lupus goes back to 400 BC when Hippocrates began diagnosing skin lesions. Although not aware, the lesions that were listed as herpes were in fact signs and symptoms of Lupus.  Over time and leading into the 12^th century terms began to change based on the location of the lesion and/or ulcers. By the mid-19^th century facial and upper body skin diseases began to be known as Lupus erythematosus and Lupus vulgaris. Throughout this time more signs and characteristics of the disease began to develop and studies began to show variations. Lupus was not evolving but it was becoming more complexed while remain the same. During the 1900’s scientist and medical professionals began to associate Lupus with other disease. One case that existed was in a female child whom showed one of the first signs of the now known butterfly facial rash. This pattern is known as an immediate sign of possible Lupus diagnosis. Emmanuel Libman and Benjamin Sacks then studied the body and blood and confirmed the relation of the erythema. This was in conjunction of a previous study conducted by Olser. With the help of this information and conclusion they named the disease as Libman-Sacks Syndrome.

            The studies continued on and used several patients that had diverse levels of skin diseases. The studies even included those whom were interrelated to have syphilis. The test conducted for syphilis gave false positives for those whom carried the lupus gene. This allowed further understanding of the connection and metamorphosis of the SLE (systemic lupus erythematosus) and LE (lupus erythematosus) antibodies. Hargraves gave us the final understanding that brought together years of study, research and misconceptions. Lupus was finally able to be tested as a single disease and the classifications then began to develop.

            The American College of Rheumatology (ACR) used Hargraves classifications and developed them until around 1997. The set classifications allowed immediate medical care in patients that may have had mild symptoms. Even with the knowledge and studies some still remain underdiagnosed and/or not diagnosed at all due to not having active symptoms. As in earlier times patients would require the physical sign of lesions and/or ulcers. Now there are blood tests that can confirm the presences of SLE or LE. 

(Medicine (Baltimore), 2018)

Stereotypes and Stereotypical Thinking

One of the primary stereotypical thinking for Lupus is that it does not exist. Many see lupus as a non-invasive ailment that happens to only older women. That is all false SLE/LE can happen to anyone no matter race, color or nationality. There are a greater percentage of women diagnosed with SLE/LE. However, men can also have Lupus and both can die from it if not treated. Leading to another myth that people cannot die from SLE/LE, instead just have poor health.

Stereotyping Lupus patients as not caring about health is something that is seen throughout the medical environment.  SLE/LE ailments can mimic other symptoms.  Allowing Lupus to be misdiagnosed or underdiagnosed because of symptoms that are concealed by others. Lupus is usually diagnosed between the teen years and/or before 30 years of age. During that time treatment is often focused on age rather than symptoms. For example, a young man age 20 has a rash with muscle and joint pain. Physician will assume young, active and will treat with over the counter medications. There would not be a thought that this rash could be SLE/LE, thus no testing. Only after approximately 6 months to a year of treatment, will the physician considered other alternative issues. Lupus is generally the last testing to be completed in younger adults.

Cultural Perceptions

            However, those whom are treated often resent the treatment or do not like the side effects of medications or the disease. Lupus can take over and leave burdens on life and its changes. SLE/LE can cause physical limitations due to internal organ damage. To correct these issue patients must adhere to a strict medication regime. This can be retributive in teen to early adult ages. Not to mention both emotionally and mentally challenging. Imagine living a life by medications and exercise but no enjoyment of career or family. Depending on the access to treatment and severity of the disease this is the life of those living with Lupus.

Works Cited

Color Atlas of Pediatric Dermatology Samuel Weinberg, N. S. (2008). Vascular, Lymphatic and Systemic Conditions. Retrieved May 25, 2021, from MedicineNet: https://www.medicinenet.com/image-collection/systemic_lupus_erythematosus_1_picture/picture.htm

David J. Tunnicliffe, D. S.-G.-W. (2015, September 28). Lupus Means Sacrifices: Perspectives of Adolescents and Young Adults With Systemic Lupus Erythematosus. Retrieved May 26, 2021, from Wiley Online Library: https://onlinelibrary.wiley.com/doi/full/10.1002/acr.22749

Medicine (Baltimore). (2018, October 19). Diagnosis of systemic lupus erythematosus by presence of Hargraves cells in eosinophilic pleural effusion. Retrieved May 25, 2021, from NCBI: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6211931/

Norman, R. A. (2016, January 19). Lupus: Open Access. Retrieved May 25, 2021, from www.longdom.org: https://www.longdom.org/open-access/the-history-of-lupus-erythematosus-and-discoid-lupus-fromhippocrates-to-the-present-Lupus-1000102.pdf