Hair and Scalp Changes in Cutaneous and Systemic Lupus Erythematosus

Abstract

Cutaneous and systemic lupus erythematosus (SLE) commonly involves the hair and scalp. Alopecia can result from direct activity of disease on the scalp or from the state of physical stress in the form of telogen effluvium. Discoid lupus erythematosus and lupus panniculitis/profundus are known to cause scarring alopecia, while accumulation of recent studies has shown that non-scarring alopecia in SLE may have different subtypes, comprising lupus erythematosus-specific and lupus erythematosus-nonspecific changes on histology. This review aims to summarize the clinical pattern, trichoscopic, histopathological, and direct immunofluorescence features of different types of alopecia in cutaneous and systemic lupus erythematosus, as well as exploring their relationship with SLE disease activity.

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

“…Nevertheless, all our patients were on hydroxychloroquine of which reports on hair hypopigmentation are rare. 1,33 Of note, all these changes were not uniform and were detected on random location on one trichoscopic field, or even showing different sizes and colours in the same hair strand. We agree with previous speculation that damage to hair matrices and dermal papilla in SLE may be selective.…”

“…This change had been observed before under the microscope and also as follicular miniaturization on histopathology. 1,4 Another frequent finding was hypopigmented hair shaft, with main differential diagnosis being the effects of drug, especially with chloroquine. Nevertheless, all our patients were on hydroxychloroquine of which reports on hair hypopigmentation are rare.…”

“…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.…”

“…Hair and scalp involvement in SLE is common and has various clinical manifestations. 1 When hair loss is present, it can either be scarring, in the form of discoid lupus erythematosus (DLE), or more commonly, non-scarring, which is further divided into diffuse, patchy and lupus hair. 2 Even without hair loss, hair shafts can be smaller in diameter, hypopigmented or fragile.…”

Geç Tanılanmış Sistemik Lupus Eritematozuslu Bir Hastaya Roy Uyum Modeli Kullanılarak Hemşirelik Bakımının Verilmesi: Bir Olgu Sunumu

“…Saç dökülmesi, saç tellerinde yapısal bozukluk (pili torti/lupus saçı) 5,6 5 Ayrıca saç tellerinin, saçlı derinin ve bazen kaş ve kirpiklerin yapısının bozulduğu/döküldüğü görülebilmektedir. 5,6 Bunun yanında saç yapısında ve tırnak yapısında değişiklikler olabilmektedir. 6,19 SLE'de en büyük sorunlardan biri de ciltte oluşan lezyonlardır (raş, diskoid lekeler vs).…”