Non-Scarring Alopecia of Lupus Erythematosus: A Comprehensive Review

    A. Perales, Dan Lipsker, B. Cribier, C. Lenormand
    TLDR Non-scarring hair loss in lupus patients often responds well to treatment and doesn't lead to scarring.
    This comprehensive review analyzed data from 237 patients across 27 publications to provide an updated overview of non-scarring alopecia (NSA) in lupus erythematosus (LE) patients. The study identified several subtypes of NSA, including diffuse NSA, patchy NSA, lupus hair, dermal cutaneous LE, and linear and annular lupus panniculitis of the scalp. Diffuse/patchy NSA and lupus hair were strongly associated with systemic LE activity, showed subtle signs of inflammation, and responded well to SLE therapy without progressing to scarring alopecia. In contrast, dermal cutaneous LE and lupus panniculitis were less associated with SLE and responded better to skin-directed therapies. The review suggests that diffuse/patchy NSA and lupus hair may be variations of a single LE-specific entity and calls for prospective studies to further explore the clinical significance of these manifestations.
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