Areata-Like Lupus as a Clinical Manifestation of Cutaneous Lupus Erythematosus

January 2022 in “ Skin Appendage Disorders ”

Karina Lopes Morais, Pedro Secchin, Alessandra Anzai, Maria Júlia Miquelão Canuto Verussa, Andréia Munck, Carolina Oliveira Costa Fechine, Neusa Yuriko Sakai Valente, Ricardo Romiti

areata-like lupus cutaneous lupus erythematosus alopecia areata nonscarring patchy alopecia trichoscopy histology direct immunofluorescence exclamation mark hairs C3 IgA IgG autoimmune infiltrate hair follicles lupus AA hair loss skin biopsy immune system

TLDR Areata-like lupus can mimic alopecia areata but is a form of cutaneous lupus erythematosus.

The document discusses a case report of a 63-year-old woman diagnosed with areata-like lupus, a form of cutaneous lupus erythematosus (CLE) that mimics alopecia areata (AA) but without systemic lupus erythematosus (SLE) involvement. The patient exhibited nonscarring patchy alopecia with trichoscopic and histological features similar to AA. However, direct immunofluorescence and histology confirmed the diagnosis of cutaneous LE. The patient responded well to treatment with triamcinolone hexacetonide, clobetasol, and minoxidil, showing significant hair regrowth over 10 months. The study emphasizes the importance of considering areata-like LE in the differential diagnosis of AA, even in the absence of systemic LE symptoms.

View this study on karger.com →

Discuss this study in the Community →

Research cited in this study

14 / 14 results

research Alopecia Areata: A Multifactorial Autoimmune Condition

148 citations, December 2018 in “Journal of autoimmunity”

Alopecia areata is an autoimmune disease causing patchy hair loss, often with other autoimmune disorders, but its exact causes are unknown.

research Alopecias in Lupus Erythematosus

39 citations, October 2018 in “Lupus Science & Medicine”

Different types of hair loss in lupus need careful diagnosis for proper treatment.

research Hair and Scalp Changes in Cutaneous and Systemic Lupus Erythematosus

46 citations, June 2018 in “American Journal of Clinical Dermatology”

Hair loss is common in lupus patients and can be permanent or reversible, depending on the type, with various treatments available.

research Alopecia Areata: A Review of Disease Pathogenesis

191 citations, May 2018 in “British journal of dermatology/British journal of dermatology, Supplement”

Alopecia areata is likely an autoimmune disease with unclear triggers, involving various immune cells and molecules, and currently has no cure.

research Trichoscopy of Alopecia Areata: An Update

89 citations, March 2018 in “The Journal of Dermatology”

Trichoscopy helps diagnose and monitor alopecia areata by looking at a combination of specific hair and scalp features.

research Syphilitic Alopecia: Uncommon Trichoscopic Findings

32 citations, July 2017 in “Dermatology practical & conceptual”

New hair and skin changes were found in a rare case of syphilis-related hair loss.

research Trichoscopic Clues for Diagnosis of Alopecia Areata and Trichotillomania in Asians

37 citations, January 2017 in “International Journal of Dermatology”

Trichoscopy helps tell apart alopecia areata and trichotillomania in Asians by looking at specific hair and scalp features.

research Trichoscopy of Dissecting Cellulitis of the Scalp: Exclamation Mark Hairs and White Dots as Markers of Disease Chronicity

15 citations, November 2016 in “Journal of The American Academy of Dermatology”

Exclamation mark hairs suggest early scalp disease, while white dots indicate it's chronic.

A Nonrandomized Study of Trichoscopy Patterns Using Nonpolarized (Contact) and Polarized (Noncontact) Dermatoscopy in Hair and Shaft Disorders

research A Nonrandomized Study of Trichoscopy Patterns Using Nonpolarized (Contact) and Polarized (Noncontact) Dermatoscopy in Hair and Shaft Disorders

34 citations, January 2014 in “International Journal of Trichology”

Polarized dermoscopy is slightly better than nonpolarized for diagnosing hair disorders, with each method having its own strengths.

research Non-Scarring Patchy Alopecia in Patients with Systemic Lupus Erythematosus Differs from That of Alopecia Areata

30 citations, October 2013 in “Lupus”

Hair loss in lupus is different from hair loss in alopecia areata and may indicate lupus activity.

research Exclamation Marks and Other Trichoscopic Signs of Chemotherapy-Induced Alopecia

33 citations, September 2012 in “Australasian Journal of Dermatology”

Chemotherapy can cause hair changes similar to alopecia areata, which might lead to misdiagnosis.

research Derivation And Validation Of The Systemic Lupus International Collaborating Clinics Classification Criteria For Systemic Lupus Erythematosus

4350 citations, May 2012 in “Arthritis & Rheumatism”

The new SLICC criteria for diagnosing lupus are more sensitive and accurate than the old criteria.

research Lupus Erythematosus: Systemic and Cutaneous Manifestations

144 citations, September 2006 in “Clinics in Dermatology”

Lupus affects the body and skin, causing joint pain and skin issues that can be treated with steroids and antimalarial drugs.

research Histopathology of Non-Scarring Alopecia

122 citations, April 1995 in “Journal of Cutaneous Pathology”

The document describes how to tell different types of non-scarring hair loss apart by looking at hair and scalp tissue under a microscope.

Related Community Posts Join

6 / 198 results

community Diffuse hair loss and scalp biopsies

in Research 692 upvotes 3 months ago

Scalp biopsies are crucial for diagnosing hair loss conditions like Diffuse Unpatterned Alopecia (DUPA) and retrograde hair loss, as treatments like finasteride and dutasteride may not be effective if other conditions are present. Combining PPAR-GAMMA agonists with retinoids could improve treatments for conditions like Lichen Planopilaris.

community Hair Remedies that Don't Work for Anybody Seeking Hair Regrowth

in Treatment 7 upvotes 4 years ago

Hair loss treatments discussed include minoxidil, finasteride, and RU58841. Salon products and supplements generally don't work for hair regrowth unless there's a severe nutritional deficiency, while hormonal treatments like estrogen and spironolactone can be effective.

community I’m 14 years old and I’m losing more hair than my dad. I’ve gone to the doctor 2 times because of this and I’ve received no help. I’m starting to feel like It’s worthless and my hairs gonna look like this forever. I don’t know how anyone could help me but it’s always worth a shot.

in Treatment 4 years ago

A 14 year old who is experiencing hair loss and has not received any help from the doctor, with advice being given to try different doctors, get tested for underlying conditions and intolerances, buzz it short as an option and treatments that could slow down or reverse the hair loss such as minoxidil, finasteride, RU58841 and addressing the cause of the hair loss.

community Not everyone should immediately go on Fin if they are starting to bald

in Finasteride/Dutasteride 21 upvotes 10 months ago

The conversation suggests that people should consult a dermatologist to understand their type of hair loss before starting treatments like finasteride or dutasteride, especially if they have autoimmune issues or low DHT. Some participants believe in starting treatment like finasteride immediately if hair loss is due to DHT, while others recommend ruling out other causes and considering minoxidil first, especially for younger individuals.

community Seeking Advice: Unusual Hair Loss at 31 Years Old - Any Insights? (M)

in Chat 15 upvotes 7 months ago

A 31-year-old man who previously had good results with minoxidil, finasteride, and nizoral for hair loss is now experiencing unusual hair loss and side effects from finasteride. Respondents suggest it might be severe retrograde alopecia and recommend exploring other treatment options due to his inability to tolerate finasteride.

community Starting Spironolactone, any ladies in here with experience or success?

in Female 56 upvotes 1 year ago

A female user starting Spironolactone treatment for thinning hair, and others sharing their experiences with Minoxidil and oral/sublingual Minoxidil as treatments.

Related Research

5 / 5 results

research Case Report of Novel Combination of Anthralin and Calcipotriene Leading to Trichologic Response in Alopecia Areata

6 citations, March 2019 in “JAAD case reports”

A new mix of anthralin and calcipotriene might help treat severe hair loss.

research Alopecia Areata: A Multifactorial Autoimmune Condition

148 citations, December 2018 in “Journal of autoimmunity”

Alopecia areata is an autoimmune disease causing patchy hair loss, often with other autoimmune disorders, but its exact causes are unknown.

research Linear Alopecia Areata

4 citations, November 2018 in “JAAD case reports”

Alopecia areata can sometimes appear as a straight line of hair loss instead of round patches.

research Hair Disorders

August 2018 in “Oxford University Press eBooks”

The document's conclusion cannot be provided because the document cannot be parsed.

research Treating Resistant Cases of Alopecia Universalis

May 2018 in “Journal of cosmetology & trichology”

Combining platelet-rich plasma therapy with prostaglandin-F eye drops can significantly regrow hair in alopecia universalis.