Hair loss in systemic lupus erythematosus can indicate active disease, and nonscarring alopecia shows changes unique to lupus on histology and direct immunofluorescence, according to researchers in Journal of the American Academy of Dermatology.

“A majority of patients present with mild diffuse alopecia, but hair loss can also be localized in patches or along the anterior hair line,” Kumutnart Chanprapaph, MD, of the division of dermatology, department of medicine, at Ramathibodi Hospital, Mahidol University, in Bangkok, and colleagues wrote. “Common trichoscopic findings were arborizing/interconnecting vessels, blue-grey speckled pigmentation and thin hypopigmented hair shafts.”

Thirty-two adult patients with SLE with nonscarring alopecia underwent a full physical/trichoscopic examination and scalp biopsy. Ten patients who had lupus without any alopecia or scalp abnormalities were included for comparison. Patients’ age, sex and duration of lupus were similar between the groups. A total of 121 specimens from 42 patients were analyzed.

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