Systemic lupus erythematosus (SLE) is an autoimmune disease that can affect 
almost any organ in the human body. Despite significant advancements in our 
understanding of SLE over the recent years, its exact mode of onset and disease 
progression remains elusive. Low concordance rates among monozygotic twins with 
SLE (as low as 24%), clustering of disease prevalence around polluted regions 
and an urban-rural difference in prevalence all highlight the importance of 
environmental influences in SLE. Experimental data strongly suggests a complex 
interaction between the exposome (or environmental influences) and genome 
(genetic material) to produce epigenetic changes (epigenome) that can alter the 
expression of genetic material and lead to development of disease in the 
susceptible individual. In this review, we focus on the available literature to 
explore the role of environmental factors in SLE disease onset and progression 
and to better understand the role of exposome-epigenome-genome interactions in 
this dreaded disease.