Alopecias in lupus erythematosus

Area of Science:

• Dermatology
• Rheumatology
• Pathology

Background:

• Hair loss is a common manifestation in lupus erythematosus (LE).
• Understanding the diverse etiologies of alopecia in LE is crucial for accurate diagnosis and classification.
• Specific hair loss patterns can be indicative of LE, while others may coexist or mimic LE-related conditions.

Purpose of the Study:

• To review and categorize the various types of hair loss associated with lupus erythematosus.
• To highlight the importance of recognizing LE-specific alopecia for diagnostic criteria.
• To differentiate between LE-specific and non-LE-specific causes of hair loss in patients with LE.

Main Methods:

• Review of histological and clinical characteristics of different alopecia types in lupus erythematosus.
• Analysis of the role of alopecia in the Systemic Lupus International Collaborating Clinics (SLICC) classification criteria for SLE.
• Discussion of coexisting conditions and differential diagnoses for hair loss in LE patients.

Main Results:

• LE-specific alopecias include discoid LE (DLE), acute LE hair loss, subacute cutaneous LE, and tumid LE.
• Lupus hair in systemic lupus erythematosus (SLE) may represent telogen effluvium.
• Alopecia areata can mimic DLE, and non-lupus hair loss (telogen/anagen effluvium) has various triggers in LE patients.

Conclusions:

• Accurate identification of hair loss etiology in LE is essential for disease classification.
• Non-scarring alopecia is a key criterion in the latest SLICC classification for SLE.
• Distinguishing LE-specific from non-specific hair loss aids in comprehensive patient management and diagnosis.