L e t t e r t o t h e E d i t o r
History of lupus erythematosus
History of lupus erythematosus
K. Holubar
Figure 1. Laurent-Théodore Biett, drawing, in his birthplace.
Hargrave's classic description of the LE cell ushered in a new era. In the 1960s the lupus band test was described and antinuclear antibodies were identified as responsible for the tissue damage (7, 8).
Laurent-Théodore Biett (1781-1840) was born in Schanf, Switzerland. (His given name was Duosch, corresponding to Théodosius rather than Théodore.) As a child, he moved with his family to France. He was educated in Paris. He joined Jean Louis Alibert at the Hôpital Saint-Louis and became his deputy. When Alibert was made physician to the king. Biett went to London and, like Rayer, became a Willanist. His lectures were largely published by his pupils Pierre Louis Alpheé Cazenave and Henry Edward Schedel (1). The term érythème centrifuge was first mentioned in the 1838 edition of their writings (2). This was later renamed lupus érythèmateux by Cazenave in 1850 (3) and the first case was presented in 1851. Hebra translated the term in 1856 and withdrew his own. Isidor Neumann reported the first histopathology in 1863 (4). Interestingly, the master used the Greco-Latin hybrid he created from French (erythematosus), whereas his assistant Isidor Neumann used a Greek-only derivative (erythematodes). The first form is used in the English-speaking world, and the latter is usual in German-speaking areas.
Moriz Kaposi published the first extensive paper in 1872 and pointed to systemic symptoms and to the danger for the patient. It took more than 70 years for LE to become known as an acronym and be recognized as a collagenosis of autoimmune nature (6).
In 1948
Figure 2. Biett's term érythème centrifuge, as given in Cazenave and Schedel's book (1838).
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*This poster was displayed at the joint meeting of the German and Austrian Academies of Science on 13/14 January 2006 in Vienna.
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History of lupus erythematosus
L e 11 e r t o t h e E d i t o r
The role of ultraviolet radiation in triggering the autoimmune phenomena is still being investigated. Today, advanced techniques permit the visible demonstration of antinuclear activity as shown in Figure 15.
Acknowledgments:
The descendants and relatives of the (Biett), Hegner, Gattiker, and Caratsch families Professor Georg Wick., M.D., Medical University of Innsbruck, Innsbruck, Austria Mr. Karl Stoeckl, Institute for the History of Medicine, Medical University of Vienna, Vienna, Austria
Mr. Kurt Kumptner and Mrs. Gerda Kornfeil, at the Kumptner Co., Vienna, Austria
Figure 3a. First naming of lupus erythemateux, 27 July 1850 (a) journal (b) text.
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Figure 3b. First case, Ann des Mal de la Peau (1851/52).
Figure 4. Pierre Louis Alphée Cazenave (1795-1877).
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Figure 6. The first presentation of LE histology in Neumann's paper (1863).
Figure 5. Isidor Neumann (1832-1906) head of the Department of Dermatology II, Vienna (© Inst Hist Med Vienna).
Figure 7. Probably the original document used by Neumann to design his drawing, mid-19th century. It was found in our files in 2005 (© Inst Hist Med Vienna).
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L e 11 e r t o t h e E d i t o r
History of lupus erythematosus
Figure 8. Reproduced from Cazenave and Schedel (1838),
designated as lupus. Due to expression on one side only, it is instead considered lupus vulgaris (Reference 1).
Figure 9. LE painted by Dr. Elfinger for Hebra (1845). Hebra's own term for LE was still seborrhoea congestiva (© Inst Hist Med Vienna).
Figure 13. The drawing by Anton Elfinger diagnosed as LE, Hebra's department (1857) (© Inst Hist Med Vienna).
Figure 10. LE as depicted by Bocourt in Cazenave's atlas (1856).
Figure 12. LE by William Bagg in Wilson's atlas (1855). The diagnosis inflammatio folliculorum was still used.
Figure 14. Moriz Kaposi (1837-1902) seating at his private desk. Vienna, Alserstrasse 28, next to the Vienna General Hospital (© Inst Hist Med Vienna).
Figure 11. Hebra withdrew his own term in favor of Cazenave's in 1866.
Figure 15. Kaposi's second, extensive publication in 1872; symptoms of LE are listed for the first time.
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Figure 16. Antinuclear antibodies (ANA). Courtesy of Professor Georg Wick, Medical University of Innsbruck.
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R E F E R E N C E S 1 Cazenave PLA, Schedel HE. Abrégé pratique des maladies de la peau. 3rd ed. Paris: Béchet jeune;
1838. p. 11.
2.	Cazenave PLA. La Lancette Française, Gazette des hôpitaux civils et militaires, 1850 Jul 27.
3.	Cazenave PLA. Lupus érythèmateux (érythème centrifuge). Ann des Maladies de la peau et de la syphilis 1850/51; 3: 297-9.
4.	Hebra F. On diseases of the skin. New Sydenham Soc, London 1866; 1: 115.
5.	Neumann I. Beitraege zur Kenntniss des Lupus erythematodes. Wien Med Wochenschr 1863; 643-6.
6.	Kaposi M. Neue Beiträge zur Kenntniss des Lupus erythematosus. Arch Derm Syphilol 1872; 4: 36-78.
7.	Holubar K, Fatovic-Ferencic S. 1902-2002: A hundred years later. Moriz Kaposi 1837-1902: a historical reappraisal. Wien Klin Wochenschr 2001; 113: 885-93 (with bibliography and LE poster).
8.	Wick G. Personal communication. 2005.
AUTHOR'S Karl Holubar MD, FRCP, GSE, Professor, Institute for the History of ADDRESS Medicine, Medical University of Vienna, Währinger Strasse 25, A-1090
Vienna, Austria, e-mail: karl.holubar@meduniwien.ac.at
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