In this episode, we review systemic lupus erythematosus (SLE), a chronic multisystem autoimmune disease driven by immune complex deposition and widespread inflammation. We discuss the epidemiology—most commonly affecting women of childbearing age—and the classic clinical presentation including fatigue, photosensitive rash, symmetric inflammatory arthritis, and constitutional symptoms. The episode highlights hallmark findings such as the malar ("butterfly") rash, cytopenias, and potential renal involvement leading to lupus nephritis. We also review key diagnostic laboratory markers including ANA, anti–double-stranded DNA, and anti-Smith antibodies, as well as important complications like avascular necrosis related to corticosteroid therapy. Finally, we outline treatment strategies centered on hydroxychloroquine, with escalation to corticosteroids or immunosuppressive therapy for more severe disease, and discuss clinical features that help differentiate SLE from rheumatoid arthritis.

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