Linear Lupus Panniculitis of the Scalp Presenting as Alopecia Along Blaschko’s Lines: A Distinct Variant of Lupus Panniculitis in East Asians?

A 32-year-old Taiwanese man exhibited linear hair loss on his scalp, following Blaschko’s lines, diagnosed as lupus panniculitis. Histopathology showed lymphoplasmacytic infiltrate and mucin deposition. Treatment with hydroxychloroquine and steroids led to hair regrowth, but recurrence occurred. This condition, reported in five East Asians, had unique features: younger onset, male predominance, reversible without scarring, fewer systemic lupus associations, exclusive scalp involvement, sparse inflammation, abundant mucin, hyaline fat degeneration, and negative immunofluorescence. The study proposed it as a distinct variant of lupus panniculitis, important for diagnosing focal or linear alopecia in East Asians.