{
  "abstract": "Objectives Systemic lupus erythematosus is a chronic autoimmune disease with multisystem involvement. One of its hallmark manifestations is the malar or butterfly rash. Although extensively described in medical literature, the presence of lupus-like features in historical artworks remains largely underexplored. Iconodiagnosis is a methodological approach that applies contemporary medical knowledge to the interpretation of historical artworks to identify pathological features. By integrating clinical reasoning with art historical analysis, iconodiagnosis offers a unique perspective. The study aims to identify depictions of malar rash in female portraits from different countries through the method of iconodiagnosis, and to discuss their relevance to the visual history of lupus.Methods The online collections of museums and institutional websites were systematically reviewed to identify female portraits from different historical periods. Eleven portraits were found to depict erythema in the malar distribution. Each artwork was analyzed collaboratively by four physicians following established iconodiagnostic guideline. The distribution, symmetry, and morphology of the rash were compared with the clinical features of lupus, while alternative explanations such as rosacea, dermatitis, or cosmetic rouge were also considered. The study was funded by TUBITAK (The Scientific and Technological Research Council of Turkey). Grant number: 323K253.Results Eleven portraits from different centuries and countries, created by artists including Ibrahim Calli, Hasan Riza, Nikolay Bogdanov-Belsky, George Henry, Jean-Marc Nattier, Francesco Montemezzano, Joseph Wright, Franz Hals, Rembrandt Harmenszoon van Rijn, Thomas de Keyser, and Jürgen Ovens, demonstrated malar rash. The depiction of malar rash in several paintings was strikingly accurate, resembling modern clinical presentations of lupus. The repeated appearance of this feature across diverse artistic and geographical contexts suggests that artists may have inadvertently documented lupus-like conditions long before their formal medical description.Conclusions These findings highlight the potential of artworks as complementary resources for medical education, enriching both diagnostic skills and interdisciplinary perspectives. Beyond their research value, the identified works can also serve as innovative teaching material for undergraduate and assistant-level medical students, fostering observation, critical thinking, and an appreciation of the intersections between art and medicine.",
  "authors": [
    {
      "affiliations": [
        "Mugla Sitki Kocman University, Faculty of Medicine, Department of Histology and Embryology, Mugla, Turkey"
      ],
      "name": "Hulya Elbe"
    },
    {
      "affiliations": [
        "Mugla Training and Research Hospital, Department of Histology and Embryology, Mugla, Turkey"
      ],
      "name": "Dilan Cetinavci"
    },
    {
      "affiliations": [
        "Mugla Sitki Kocman University, Faculty of Medicine, Department of Histology and Embryology, Mugla, Turkey"
      ],
      "name": "Anil Yucel"
    },
    {
      "affiliations": [
        "Mugla Sitki Kocman University, Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Mugla, Turkey"
      ],
      "name": "Begum Asan"
    }
  ],
  "title": "PO:12:324 Faces of lupus: historical portraits depicting malar rash through the iconodiagnosis",
  "uid": "25a61ad8-2488-5acb-9e3d-e2ec827b0f95"
}