Alopecias in lupus erythematosus

Several patterns of hair loss can occur in lupus erythematosus (LE). Alopecias which show histological characteristics of LE are LE-specific, and include discoid LE (DLE), diffuse or patchy hair loss in acute LE, subacute cutaneous LE, and rarely tumid LE. Lupus hair in SLE is a poorly characterised entity and may be a form of telogen effluvium. Alopecia areata can coexist with LE and may mimic DLE. Non-lupus alopecias such as telogen effluvium and anagen effluvium have a myriad of causes which include disease flares, drugs and stress in the setting of LE. The latest validated Systemic Lupus International Collaborating Clinics classification criteria for SLE includes non-scarring alopecia as a criterion; therefore, recognising the aetiology of hair loss in the setting of LE is crucial in classifying a patient to have systemic disease.