The Frequency of Non-Scarring Alopecia in Autoimmune Connective Tissue Diseases

Autoimmune connective tissue diseases (ACTDs) are relatively rare systemic diseases featured by immune dysregulation and often have prominent cutaneous manifestations. The most common is systemic lupus erythematosus (SLE), dermatomyositis (DM), systemic sclerosis (SSc), Sjogren syndrome (SJO), undifferentiated connective tissue disease (UCTD), and mixed connective tissue disease (MCTD). Alopecia is one of the most common symptoms of these diseases, with significant impact on the quality of life of these patients.

Our aim is to better characterize non-scarring alopecia in ACTDs.

A retrospective chart review study of patients seen at the Autoimmune Connective Tissue Diseases clinic at Massachusetts General Hospital, Boston, MA, was conducted from November 2012 to January 2018. The study was reviewed and approved by Partners IRB.

A total number of 1486 visits where 734 were new patients, and 241 patients with ACTDs included in our analysis. Of the new patients, 80% were female and 20% were male, with an average age of 51 years. Of patients with MCTD, 46.6% presented with non-scarring alopecia at their initial evaluation. Of patients with SLE, 36% presented with non-scarring alopecia. Of the 32 patients with SJO, 28% reported diffuse non-scarring alopecia. Of patients with UCTD, 22% presented with diffuse non-scarring alopecia. Only 9.5% of our patients with DM and 9% of our patients with SSc presented with diffuse non-scarring alopecia.

Alopecia is common in all ACTDs and often under evaluated. Treatment of alopecia in ACTDs can be challenging, and oftentimes patients require joint management and work-up. J Drugs Dermatol. 2025;24(3):246-249. doi:10.36849/JDD.7750.