An Atypical Clinical Presentation of Alopecia in Two Patients with Systemic Lupus Erythematosus

    October 2019 in “ JAAD Case Reports ”
    Irina Lerman, Ritesh Agnihothri, Glynis Scott, Christopher T. Richardson
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    TLDR Two patients with lupus had an unusual type of hair loss not typical for the disease but improved with treatment.
    The document described two male patients with systemic lupus erythematosus (SLE) who exhibited an unusual type of alopecia with large circular nonscarring alopecic plaques featuring central scarring and hyperpigmentation, which is not typical for lupus-related hair loss. Histological examination of biopsies showed changes consistent with lupus, such as perifollicular lymphocytic infiltrate, loss of hair follicles, and increased dermal mucin. Following their SLE diagnosis based on serologic tests and clinical symptoms, the patients were treated with hydroxychloroquine and topical steroids. One of the patients experienced regrowth of vellus hair after 6 weeks of treatment. These cases underscore the importance of considering systemic disease in the evaluation of unusual patterns of hair loss, including both scarring and nonscarring alopecia.
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