77. MDSOAPBRAIN - An Approach to Systemic Lupus Erythematosus

Systemic lupus erythematosus (SLE) is a chronic autoimmune disorder where the immune system mistakenly attacks the body’s own tissues through autoantibody formation and immune complex deposition. Predominantly affecting women and certain ethnic populations, the disease presents with heterogeneous symptoms ranging from the classic malar "butterfly" rash and photosensitivity to severe organ involvement like lupus nephritis or central nervous system complications. Diagnosis relies on a combination of clinical findings—often organized by the MD-SOAP-BRAIN mnemonic—and laboratory markers such as antinuclear antibodies (ANA) and more specific anti-double-stranded DNA. Management focuses on long-term stabilization using antimalarial therapies like hydroxychloroquine, supplemented by steroids and immunosuppressants such as mycophenolate for acute flares. Lifestyle modifications, including strict UV protection and smoking cessation, are essential to mitigate disease progression and associated risks like atherosclerotic heart disease.