A Case of Dyschromatosis Universalis

    March 2004 in “ Journal of The American Academy of Dermatology ”
    Latanya Benjamin, Andrea B. Trowers, George W. Elgart, Lawrence A. Schachner
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    TLDR Patients with SLE experienced non-scarring hair loss with fewer hair follicles, and DIF did not help identify lupus.
    The study aimed to characterize the histologic features of diffuse hair loss in patients with systemic lupus erythematosus (SLE). Over a 3-month period, 8 patients from a single rheumatology practice, aged between 46 and 75, participated by completing a questionnaire, having scalp photographs taken, and undergoing scalp biopsies. All patients had active SLE and an average disease duration of 13 years. They exhibited diffuse non-scarring hair loss without scalp inflammation, and three showed a positive hair pull test for telogen hair. Histological examination revealed no inflammation, scarring, follicular plugging, or other abnormalities, but a decrease in total hair follicles with a median count of 14. Direct immunofluorescence (DIF) identified lupus in four patients. The study concluded that patients with SLE and diffuse hair loss had non-scarring alopecia with a reduction in total hair follicles, and DIF was not useful for identifying lupus in these cases. The underlying cause of follicular drop out in these women remains unknown.
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