Non-Scarring Patchy Alopecia in Patients with Systemic Lupus Erythematosus Differs from That of Alopecia Areata

    October 2013 in “ Lupus
    Y Ye, Ying Zhang, Yi Gong, X Zhang, Sillani Caulloo, B Zhang, Cai Zhang, Jiong Yang, Kevin J. McElwee, X Zhang
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    TLDR Hair loss in lupus is different from hair loss in alopecia areata and may indicate lupus activity.
    The 2013 study compared non-scarring patchy alopecia in 21 patients with systemic lupus erythematosus (SLE) to 21 patients with alopecia areata (AA), revealing distinct differences between the two conditions. SLE alopecia was characterized by incomplete hair loss, hair shaft thinning, hypopigmentation, and angiotelectasis, while AA alopecia featured complete hair loss, exclamation-mark hairs, black dots, and broken hair. Histopathological examination showed perivascular inflammation in SLE alopecia, contrasting with the "swarm of bees" lymphocytic pattern seen in AA. After treatment, none of the SLE patients experienced alopecia relapse, while 41.7% of AA patients did. The study concluded that SLE-associated alopecia has unique features and may be a cutaneous sign of SLE, suggesting the importance of serological autoantibody tests for accurate diagnosis and indicating that local vasculitis may play a role in the pathogenesis of SLE alopecia.
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