Today's therapeutic options and concepts have greatly improved the chances of SLE patients to live a long and good life with lupus erythematosus. However, this is the very reason why SLE continues to be a considerable challenge for physicians. The broad spectrum of possible organ involvement requires every rheumatologist to be a "full-blooded" internal medicine specialist. Flares, infections and vascular events usually cannot be ruled out in the long run and necessitate vigilance both on the patient's and the physician's side. In addition, psychological factors often have a significant impact on the overall picture. Nevertheless, simple and straightforward rules can be formulated for most situations, as was done for rheumatoid arthritis ( RA). This review aims to outline these rules.