Cross‐sectional study of hair loss patterns in 122 Korean systemic lupus erythematosus patients: A frequent finding of non‐scarring patch alopecia

Abstract

Although non-scarring diffuse hair loss has been frequently observed in systemic lupus erythematosus (SLE) patients, the pattern of hair loss with regard to its frequency in SLE has been rarely studied. The aim of this cross-sectional study was to evaluate the hair loss patterns in SLE during the course of disease. We evaluated 122 SLE patients (age range, 13-71 years; mean age, 32.7 +/- 10.6; female : male ratio, 12.6:1), by conducting interviews about hair loss patterns before and after a diagnosis of SLE using a questionnaire format. History taking and physical examinations were done at the time of interview, and photographs were taken to discriminate the active LE-specific scarring hair loss from the LE-nonspecific diffuse hair loss. Frequency and correlation analysis were performed on the data from the interviews and photographs for determining their relation with the SLE Disease Activity Index (SLEDAI). We found that 104 patients experienced at least one hair loss event before or during the course of SLE. Eighteen patients experienced patch alopecia, including eight who experienced this malady both before and after the diagnosis; thus, the overall prevalence of patch alopecia was 14.8% (18/122). Eighty-six patients experienced hair loss after diagnosis, of which non-scarring diffuse hair loss was the most common pattern (65.1%, 56/86) followed by non-scarring patch alopecia (15.1%, 13/86). The interview survey failed to identify a statistically significant relationship between the hair loss pattern and the SLEDAI. Our results suggest that non-scarring patch alopecia is also an important pattern in SLE that should be included in the differential diagnosis of alopecia areata and confirmed by histopathological examination.

Prevalence and factors associated with telogen effluvium in adult females at Makkah region, Saudi Arabia: A retrospective study

“…A few of the patients (2.2%) with systemic lupus erythematosus were presented with TE, which is reported in other studies (Yun et al, 2007;Trueb, 2010), but its mechanism is yet to be determined.…”

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

“…Herein, we report four female patients with SLE who presented with diffuse hair loss, as well as with hair loss of the axillary and pubic regions in one case which progressed to an AU‐like condition. It has been previously reported that non‐scarring diffuse hair loss is frequently (65.1%) observed in patients with SLE, especially women 7,8 . Furthermore, hair loss in SLE has been found to correlate with the severity of SLEDAI scores 4,11,12 .…”

“…Hair loss is a common phenomenon in 17.3–82.5% of patients with systemic lupus erythematosus (SLE) manifesting as a chief primary complaint occurring during the active phase of the autoimmune condition 1–6 . Hair loss in SLE has previously been grouped with other non‐scarring types of hair loss and identified as telogen effluvium, patchy alopecia or ‘lupus hair’ 7,8 . In contrast, hair loss in discoid lupus erythematosus involves a scarring type of hair loss 7,8 …”

“…Hair loss in SLE has previously been grouped with other non‐scarring types of hair loss and identified as telogen effluvium, patchy alopecia or ‘lupus hair’ 7,8 . In contrast, hair loss in discoid lupus erythematosus involves a scarring type of hair loss 7,8 …”

Alopecias

“…Yun et al documented hair loss events in 122 patients with SLE before and after their SLE diagnosis [ 53 ]. In total, 104 patients experienced some form of hair loss.…”