[Early lupus erythematosus]

Early diagnosis of systemic lupus erythematosus (SLE) is a challenge even for experienced rheumatologists due to the heterogeneous appearance of the disease. The initial phase of SLE often comprises unspecific general symptoms and only few characteristic clinical and laboratory abnormalities in the early course. Seriously affected patients meet the classification criteria in early stages but many other affected patients do not. A concentration only on young women as possible new cases means that more than 50 % of all persons affected will not be identified. Therapy is mainly guided by the type and severity of symptoms. Organ manifestations need to be examined at each presentation because there is a high possibility for modification in the course of the disease especially in the early stages. Early intervention should prevent increasing damage. Key elements of medical treatment are antimalarial agents. Furthermore, control of co-morbidities and optimization of lifestyle are crucial.