Hair Disorders in Autoimmune Diseases

Alopecia, or hair loss, is a common symptom in several autoimmune diseases such as lupus erythematosus, dermatomyositis, and scleroderma, and can indicate disease activity. In systemic lupus erythematosus (SLE), hair loss affects approximately 50% of patients, and can be the initial sign of the disease. The hair loss can range from scarring alopecia, typical of discoid lupus erythematositis (DLE), to non-scarring alopecia, commonly seen in acute LE. Scarring alopecia in chronic DLE is a lupus-specific cutaneous lesion, with the scalp involved in almost 60% of cases. One-third of cases of scalp DLE progress to irreversible scarring alopecia. Non-scarring alopecia is frequently observed in SLE, especially during exacerbations. The pathogenesis of non-scarring alopecia in SLE is not fully understood, but high levels of proinflammatory cytokines may negatively affect the hair growth cycle. The document also discusses hair disorders in other autoimmune diseases and emphasizes the importance of a complete dermatological examination, including trichoscopy, in patients experiencing hair loss. Prompt and accurate diagnosis is crucial to initiate specific treatment, prevent irreversible scarring alopecia, achieve complete hair regrowth, and improve overall quality of life.