Diffuse Hair Loss in a Patient With Systemic Lupus Erythematosus
August 2023
in “
JAAD Case Reports
”
systemic lupus erythematosus Fibrosing alopecia in a pattern distribution FAPD lymphocytic infiltrate perifollicular lamellar fibrosis miniaturized hair follicles lymphocytic cicatricial alopecia Frontal fibrosing alopecia FFA androgenetic alopecia hydroxychloroquine methotrexate topical clobetasol oral minoxidil intralesional Kenalog hair transplantation SLE androgenic alopecia Plaquenil Trexall Clobex Rogaine triamcinolone hair transplant
Studysummary This report describes a 57-year-old woman with fibrosing alopecia in a pattern distribution, who experienced hair regrowth with combined treatment including hydroxychloroquine and other topical and oral therapies. Our plain-language summary of this paper — not a Tressless recommendation.
A 57-year-old woman with systemic lupus erythematosus, who had been experiencing hair loss for 20 years, was diagnosed with Fibrosing alopecia in a pattern distribution (FAPD). This diagnosis was based on her hair loss pattern and histopathology showing lymphocytic infiltrate around the hair follicle, perifollicular lamellar fibrosis, and miniaturized hair follicles. FAPD is a lymphocytic cicatricial alopecia that has overlapping features of Frontal fibrosing alopecia (FFA) and androgenetic alopecia. The patient was treated with hydroxychloroquine, methotrexate, topical clobetasol, oral minoxidil, and intralesional Kenalog injections, which resulted in hair regrowth. The study concluded that hair transplantation is not recommended for FAPD treatment due to lack of supporting evidence.
