Severe Diffuse Non-Scarring Hair Loss in Systemic Lupus Erythematosus: Clinical and Histopathological Analysis of Four Cases

    Yi Gong, Y. Ye, Ying Zhang, Sillani Caulloo, X. Chen, B. Zhang, Cai Zhang, X. Zhang
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    TLDR Hair loss in systemic lupus erythematosus patients is unique and improves with treatment.
    The study examined four female patients with systemic lupus erythematosus (SLE) aged 41, 39, 14, and 48, who suffered from severe diffuse non-scarring hair loss, affecting 55%, 100%, 60%, and 55% of their scalp area, respectively. Dermoscopic analysis revealed signs such as scaling, perifollicular telangiectasia, increased short vellus hairs, focal atrichia, and reduced hair shaft pigmentation. Histopathological examination showed typical SLE-related changes, including epidermal atrophy, basement membrane zone degeneration, pigment incontinence, and mild lymphocytic infiltrates around blood vessels and hair follicles. Following SLE treatment, there was an improvement in disease activity and hair regrowth. The study concluded that hair loss in SLE patients has unique clinical, dermoscopic, and histopathological characteristics that distinguish it from other types of hair loss.
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