Severe diffuse non‐scarring hair loss in systemic lupus erythematosus – clinical and histopathological analysis of four cases

Gong, Yi; Ye, Y.; Zhang, Ying; Caulloo, Sillani; Chen, X.; Zhang, B.; Zhang, Cai; Zhang, X.

doi:10.1111/j.1468-3083.2011.04388.x

Cited by 23 publications

(31 citation statements)

References 16 publications

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“…21,31 For non-scarring cases, previous studies on fewer than 30 subjects had reported telangiectasia, scaling, reduction in number and diameter of hair, along with hypopigmented hair shafts. 5,6 To the best of our knowledge, we have collected trichoscopic findings of normal-looking or nonscarring scalp from the largest group of SLE patients. As there is limited data on trichoscopy in normal Asian population, enrolling normal controls with similar age and gender distribution for comparison has allowed assessments for the odds of having SLE.…”

Section: Discussionmentioning

confidence: 99%

“…1,3,4 In addition, scalp changes, especially telangiectasias, were also frequently observed throughout the scalp of SLE patients. 1,5,6 Histopathological study and direct immunofluorescence (DIF) of these changes had demonstrated specific lupus erythematosus features, suggesting a direct effect of SLE activity on the scalp. [5][6][7] Trichoscopy is a non-invasive tool that has become standard practice in hair and scalp evaluation.…”

Section: Introductionmentioning

confidence: 99%

“…1,5,6 Histopathological study and direct immunofluorescence (DIF) of these changes had demonstrated specific lupus erythematosus features, suggesting a direct effect of SLE activity on the scalp. [5][6][7] Trichoscopy is a non-invasive tool that has become standard practice in hair and scalp evaluation. It is convenient and practical, allowing detailed examination of both hair and scalp changes.…”

Section: Introductionmentioning

confidence: 99%

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Trichoscopic signs in systemic lupus erythematosus: a comparative study with 109 patients and 305 healthy controls

Suchonwanit

Udompanich

Thadanipon

et al. 2019

Acad Dermatol Venereol

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Background Hair and scalp involvement in systemic lupus erythematosus (SLE) can manifest as scarring alopecia, non-scarring alopecia or scalp/hair shaft changes without apparent hair loss. While trichoscopic signs in chronic cutaneous lupus are well established, data on SLE patients with normal-looking or non-scarring scalp are limited.Objectives To investigate trichoscopic features of SLE patients without chronic cutaneous scalp lesions and compare the findings with normal controls, as well as determine which feature associates with systemic disease. Furthermore, we aim to explore different clinical presentations of the scalp in SLE patients and their association with disease activity.Methods Trichoscopic photographs were taken from patients and healthy controls and evaluated by one blinded hair specialist. For SLE patients, their clinical presentations and evaluations for cutaneous, extracutaneous involvement; SLE Activity Index 2000 (SLEDAI-2K) score were documented. ResultsOf 109 SLE patients and 305 healthy controls were included. Hair shaft changes were significantly more common in SLE and associated with higher SLEDAI-2K (P < 0.05). The most common feature was prominent arborizing blood vessels (60.6% vs. 18.4%, P < 0.001), followed by thick arborizing blood vessels (57.8% vs. 10.2%, P < 0.001), black dots (47.7% vs. 2%, P < 0.001), brown scattered pigmentation (5.5% vs. 0.7%, P = 0.005) and blue-grey speckled pigmentation (44% vs.0.3%, P < 0.001). When hair loss is diffuse and severe, there were associations with haematologic (P = 0.002) and renal involvement (P = 0.027 for proteinuria > 500 mg/day, P = 0.004 for proteinuria > 1 g/day).Conclusions Trichoscopic examination is a valuable tool for SLE diagnosis and monitoring. Severe diffuse non-scarring alopecia most likely indicates active disease.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Trichoscopic signs in systemic lupus erythematosus: a comparative study with 109 patients and 305 healthy controls

Suchonwanit

Udompanich

Thadanipon

et al. 2019

Acad Dermatol Venereol

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“…Dermoscopy shows scalp atrophy, loss of the honeycomb pattern in black patients, loss of follicular opening, arborizing telangiectasia, and keratotic plugs. The presence of red dots indicates that the disease is still reversible [67][68][69][70].…”

Section: Lupus Erythematosusmentioning

confidence: 99%

Alopecias Due to Drugs and Other Skin and Systemic Disorders

Guzmán-Sánchez¹,

Asz-Sigall²

2015

Alopecias - Practical Evaluation and Management

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In this chapter, we will discuss the most common alopecias due to drugs and other skin and systemic disorders. The following hair disorders will be analyzed: telogen effluvium (acute and chronic); anagen effluvium; folliculotropic mycosis fungoides; and folliculitis due to bacteria, fungi, parasites, human immunodeficiency virus disease, lupus erythematosus, and sarcoidosis. We will cover topics including the epidemiology, etiology, clinical picture, and diagnosis of and current treatments for each disease.

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“…Die Dermatoskopie zeigt hier eine Atrophie der Kopfhaut, einen Verlust des Wabenmusters bei Patienten mit schwarzer Hautfarbe, einen Verlust von Follikelöffnungen, verzweigte Teleangiektasien und eine Hyperkeratose. Das Vorhandensein roter Punkte deutet darauf hin, dass die Erkrankung noch reversibel ist [67,68,69,70]. …”

Section: Lupus Erythematodesunclassified

Alopezien infolge von Medikamenten oder von anderen Haut- und systemischen Erkrankungen

Guzmán-Sánchez¹,

Asz-Sigall²

2016

Kompass Dermatol

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In diesem Kapitel werden die häufigsten Formen der Alopezie vorgestellt, die durch medikamentöse Therapien oder durch andere Hautkrankheiten und systemische Erkrankungen hervorgerufen werden können. Die folgenden Haarerkrankungen werden analysiert: das Telogeneffluvium (akut und chronisch); das Anageneffluvium; die follikulotrope Mycosis fungoides sowie Follikulitiden infolge von Bakterien, Pilzen, Parasiten, humanem Immundefizienzvirus, Lupus erythematodes und Sarkoidose. Dabei werden die Epidemiologie und Ätiologie, die klinische Manifestation und Diagnose sowie die aktuellen Therapien der einzelnen Krankheiten abgedeckt.

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Severe diffuse non‐scarring hair loss in systemic lupus erythematosus – clinical and histopathological analysis of four cases

Abstract: The severe type of hair loss in patient with SLE presents a unique set of clinical, dermoscopic and histopathological features.

Cited by 23 publications

References 16 publications

Trichoscopic signs in systemic lupus erythematosus: a comparative study with 109 patients and 305 healthy controls

Trichoscopic signs in systemic lupus erythematosus: a comparative study with 109 patients and 305 healthy controls

Alopecias Due to Drugs and Other Skin and Systemic Disorders

Alopezien infolge von Medikamenten oder von anderen Haut- und systemischen Erkrankungen

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