A Neglected Case of Systemic Lupus Erythematosus Presenting with Degos' Skin Disease and Diffuse Non-Scarring Alopecia with Dramatic Response to Treatment, Clinically and Dermoscopically

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.

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.

Dihydrotestosterone (DHT) impacts various skin conditions, including Androgenetic alopecia and seborrheic dermatitis, by causing overactivity in sebaceous glands. Topical medications Tacrolimus and Clobetasol can reduce these inflammatory conditions, and treatments like RU58841, Minoxidil, and Finasteride may also be beneficial.

Scalp biopsies are crucial for diagnosing hair loss conditions like Diffuse Unpatterned Alopecia (DUPA) and retrograde hair loss, as treatments like finasteride and dutasteride may not be effective if other conditions are present. Combining PPAR-GAMMA agonists with retinoids could improve treatments for conditions like Lichen Planopilaris.

The user reports that using topical Dutasteride has stopped their hair loss, and they are curious about potential side effects and regrowth. They also mention having scalp psoriasis and past SSRI use affecting libido.

A 19-year-old female with Diffuse Alopecia was advised by a dermatologist to use vitamin supplements, a hair serum, and antifungal drops, leading to some improvement. Other users suggested treatments like minoxidil, microneedling, and consulting a different dermatologist for further advice.