This article discusses the clinical features of tumid lupus erythematosus and emphasizes its importance as a differential diagnosis for noncicatricial alopecia, highlighting a case similar to alopecia areata without reporting new clinical results.
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February 2025 in “Journal of Drugs in Dermatology”
This report describes two cases of cutaneous lupus erythematosus mimicking alopecia areata, highlighting the importance of considering CLE in the diagnosis of patchy hair loss to prevent scarring alopecia.
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.
A 19-year-old is experiencing rapidly progressing male pattern baldness and is unsure whether to start Minoxidil now or wait until they can access Finasteride. They currently use Ketoconazole shampoo and are concerned about the long-term commitment and potential shedding associated with Minoxidil.
Lichen Planopilaris (LPP) is an autoimmune condition causing permanent hair loss and fibrosis, often misdiagnosed. Treatments include pioglitazone, topical corticosteroids, anti-inflammatory medication, and Jak inhibitors.
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.
Men with hair loss might have lichen planopilaris (LPP), which can mimic androgenetic alopecia, leading to misdiagnosis and ineffective treatment with finasteride or dutasteride. Proper diagnosis, including biopsies, is crucial to distinguish between androgenetic alopecia and conditions like LPP.
What is tofacitinib, and why is it discussed in relation to autoimmune-related hair loss such as alopecia areata?Tofacitinib is a prescription JAK inhibitor approved for rheumatoid arthritis, psoriatic arthritis and ulcerative colitis — not for alopecia areata. It is discussed for hair loss because a 2014 case report and a 2016 open-label trial reported regrowth in severe alopecia areata, but that use is off-label, the regrowth relapsed after stopping, and the drug carries an FDA boxed warning.
Is bimatoprost effective for people with alopecia areata?Bimatoprost is approved only for eyelashes; for alopecia areata the evidence is a few small studies with mixed results. Near the eyes it can darken the iris, a change its label says is likely to be permanent.