Letters: CD4+ Lymphocytopenia in Systemic Lupus Erythematosus

A 27-year-old male with diffuse hair loss, including the donor area, did not respond to finasteride, dutasteride, or minoxidil. He suspects his hair loss may be linked to a mild connective tissue disorder, possibly affecting the structural support of hair follicles, rather than being purely hormonal.

Lichen Planopilaris (LPP) is an autoimmune condition causing permanent hair loss and fibrosis, often misdiagnosed. Treatments include pioglitazone, topical corticosteroids, anti-inflammatory medication, and Jak inhibitors.

Low Dose Naltrexone (LDN) may reduce inflammation in alopecia conditions. It is discussed as a potential adjunct treatment with finasteride or dutasteride for androgenic alopecia.

The user is experiencing diffuse thinning and inflammation despite using 2.5mg dutasteride daily, ciclopirox, and ketoconazole shampoos. They are considering treatments like hydroxychloroquine and JAK inhibitors due to suspected scarring alopecia and have faced challenges in obtaining a scalp biopsy.

Prolactin may contribute to hair loss, but targeting its receptor won't cure androgenetic alopecia. ABS-201 could be a useful alternative or adjuvant therapy, similar to JAK inhibitors, but not more effective than HMI-115.

The user is experiencing intense hair shedding all over the scalp after applying pyrilutamide to the hairline and taking oral castor oil. They are also using topical finasteride and latanoprost, but are unsure which treatment is causing the shedding.