Scalp involvement with hair loss is common in systemic lupus erythematosus. Discoid lupus erythematosus may cause scarring alopecia, characterized by well-delimited erythematous plaques with scales, follicular hyperkeratosis and atrophy, which is considered a trichological emergency. Early diagnosis and treatment are necessary in order to prevent permanent hair loss. We describe a 44 years’ old female patient with systemic lupus erythematosus for 4 years, with multiple areas of occipitoparietal alopecia, erythematous plaques, atrophy, scales and some bloody crusts. Trichoscopy, histopathology and direct immunofluorescence led to the diagnosis of discoid lupus erythematosus. After 9 months treatment with thalidomide there was complete hair regrowth.
A 32-year-old male presented with lesions in the oral mucosa developing over a period of one year. Since 2006, the patient maintained a low CD4 1 lymphocyte count due to an HIV infection. On physical examination, multiple rose/pink-to-white papules and plaques with a soft consistency were found on the lower and upper portion of the lips and gums (Fig 1). Histopathology of the skin by routine staining showed parakeratosis,
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