Epidemiological, Clinical, Trichoscopic, and Histopathological Features of Lupus Erythematous Mimicking Alopecia Areata: A Multicenter Retrospective Study

2022 ◽  
pp. 1-5
Author(s):  
Daniel Fernandes Melo ◽  
Paulo Müller Ramos ◽  
Matilde Iorizzo ◽  
Caren dos Santos Lima ◽  
Erica Baptista Pinto ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Early Diagnosis ◽  
Hair Loss ◽  
Alopecia Areata ◽  
Lupus Erythematosus ◽  
Medical Records ◽  
High Specificity ◽  
Histopathological Features ◽  
Brown Discoloration ◽  
Perivascular Inflammation

<b><i>Introduction:</i></b> All types of lupus erythematosus (LE) may cause hair loss. Nonscarring alopecia was correlated with systemic LE, based on its high specificity. Discoid LE can also appear as nonscarring patches in early stages. Patchy alopecia LE-specific may also mimic alopecia areata (AA) – which can co-occur with LE. The distinction is fundamental to early diagnosis and effective treatment. This study aims to analyze clinical, epidemiological, trichoscopic, and histopathological features of patients with patchy LE-specific alopecia, nonscarring type, mimicking AA. <b><i>Methods:</i></b> This is a multicentric retrospective study. We reviewed the medical records of patients with a confirmed diagnosis of LE mimicking AA. <b><i>Results:</i></b> Ten patients were included (90% female) with a mean age of 45.9 years. Clinically, 60% showed erythema and 70% presented incomplete hair loss. The most common trichoscopic findings were interfollicular arborizing vessels (90%) and scattered brown discoloration (80%). On histopathology, perivascular inflammation (85.7%), peribulbar lymphocytes (85.7%), and dermal pigment incontinence (71.4%) were present in most cases. <b><i>Discussion/Conclusion:</i></b> Trichoscopy was found as an essential first step for the patchy alopecia diagnosis, enabling to differentiate LE from AA. Putting it mildly, trichoscopy raises the suspicion that leads to a biopsy, increasing the diagnostic accuracy with better outcome for patients.

scholarly journals A 5-year Retrospective Study on Alopecia in a Tertiary Hospital in Southern Nigeria

2020 ◽  
Vol 8 (3) ◽  
pp. 175-182
Author(s):  
C.R. Madubuko ◽  
B.U. Okwara
Keyword(s):  
Retrospective Study ◽  
Teaching Hospital ◽  
Hair Loss ◽  
Lupus Erythematosus ◽  
Tertiary Hospital ◽  
Discoid Lupus Erythematosus ◽  
Female Ratio ◽  
Benin City ◽  
The University ◽  
Étude Rétrospective

Background: Alopecia is a common condition accounting for the top ten morbidities seen in patients that present at dermatology outpatient clinics in Nigeria.Aim: This retrospective study aimed at documenting the prevalence and types of alopecia in the skin clinic at the University of Benin Teaching Hospital between December 2014 and December 2019. Methods: The medical records of all patients with alopecia attending dermatological outpatient clinic between December 2014 to December 2019 were analyzed retrospectively for this descriptive observational study. An approval for the study was obtained from the Ethics Committee of the University of Benin Teaching Hospital, Benin-city, Nigeria. The diagnosis of Hair loss was essentially clinical, confirmed where expedient with a skin biopsy. Dermatological tools like Dermoscopes were also used to boost diagnostic accuracy when necessary. The patients were also evaluated for presence of other cutaneous and systemic disorders. Results: During the 5year study period, 106 patients with hair loss (6.6%%) were observed. The youngest patient was 2months old and the oldest patient was 90years old. The males constituted 61.3% of patients observed while the females accounted for 38.7% of patients seen. The male to female ratio was 1.6:1. Discoid lupus erythematosus of the scalp, was the most common disorder 29(29.4%). Alopecia areata occurred in23(27.7%); tinea capitis in 15(14,2%); Acne keloidalis nuchae in 14(13.2%); seborrheic dermatitis10(9.4%); and folliculiltis delcavans 9(8.5%). Less commonly observed causes of alopecia included androgenetic alopecia 2(1.9%); traction alopecia 2(1.9%); lichenplanopilaris 1(0.9%) and nevus sebaceum 1(0.9%). Conclusion: There is a need for studies to further describe and proffer solutions to common causes of alopecia in our community. Keywords: Retrospective study, Alopecia, Tertiary hospital, Benin French title: Une étude rétrospective de cinq (5) ans sur l'alopécie dans un hôpital tertiaire du Sud au Nigéria Contexte général de l'étude: L'alopécie est une condition de classement courante qui explique les dix principales morbidités observées chez les patients qui se présentent dans des cliniques externes de dermatologie au Nigéria.Objectif de l'étude: Cette étude rétrospective visait à documenter la prévalence et les types d'alopécie à la clinique externe de dermatologie de l'hôpital universitaire du Bénin entre décembre 2014 et décembre 2019.Méthode de l'étude: Il s'agissait d'une étude rétrospective de patients présentant principalement une perte de cheveux. Les données ont été obtenues à partir des dossiers cliniques et des notes cliniques des patients.Résultats de l'étude: Au cours de la période d'étude de 5 ans, 106 patients sur 1 600 personnes fréquentant la clinique de la peau ont eu une perte de cheveux constituant une prévalence de 6,6%. Les patients vus étaient âgés de 2 mois à 90 ans. Plus d'hommes (61,3%) que de femmes (38,7%) ont été vus; avec un rapport de 1,6: 1. Le lupus érythémateux discoïde du cuir chevelu était le trouble le plus courant «insérer un nombre absolu» (29,4%). L'alopécie areata est survenue en «insérer le nombre absolu» 27,7%; tineacapitis en «insérer le nombre absolu» 14,2%; Acné  keloidalisnuchae en «insérer le nombre absolu» 13,2%; dermatite séborrhéique «insérer le nombre absolu» 9,4%; et folliculiltisdelcavans «insérer le nombre absolu» 8,5%. Les causes d'alopécie moins fréquemment observées comprenaient l'androgénétopécie (1,9%); alopécie de traction (1,9%); lichenplanopilaris (0,9%) et naevus sébacé (0,9%)Conclusion: Des études sont nécessaires pour décrire et proposer des solutions aux causes courantes d'alopécie dans notre communauté. Mots-clés: Alopécie, lupus érythémateux discoïde, alopéciaareata, acné keloidalisnuchae

scholarly journals Discoid Lupus Erythematosus of the Scalp in a Patient with Systemic Lupus Erythematosus: A Case Report with Complete Hair Regrowth

2021 ◽  
Vol 79 (2) ◽  
pp. 155-158
Author(s):  
Cleide Garbelini-Lima ◽  
Gabriela Evangelista de Almeida ◽  
Sidharta Quércia Gabdelha ◽  
Andrea Cavalcante de Souza ◽  
Mara Lúcia Gomes de Souza ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Case Report ◽  
Early Diagnosis ◽  
Hair Loss ◽  
Lupus Erythematosus ◽  
Direct Immunofluorescence ◽  
Discoid Lupus Erythematosus ◽  
Systemic Lupus ◽  
Hair Regrowth ◽  
Erythematous Plaques

Scalp involvement with hair loss is common in systemic lupus erythematosus. Discoid lupus erythematosus may cause scarring alopecia, characterized by well-delimited erythematous plaques with scales, follicular hyperkeratosis and atrophy, which is considered a trichological emergency. Early diagnosis and treatment are necessary in order to prevent permanent hair loss. We describe a 44 years’ old female patient with systemic lupus erythematosus for 4 years, with multiple areas of occipitoparietal alopecia, erythematous plaques, atrophy, scales and some bloody crusts. Trichoscopy, histopathology and direct immunofluorescence led to the diagnosis of discoid lupus erythematosus. After 9 months treatment with thalidomide there was complete hair regrowth.

scholarly journals Alopecias in lupus erythematosus

2018 ◽  
Vol 5 (1) ◽  
pp. e000291 ◽  
Author(s):  
Josef Symon Salgado Concha ◽  
Victoria P Werth
Keyword(s):  
Hair Loss ◽  
Alopecia Areata ◽  
Lupus Erythematosus ◽  
Systemic Disease ◽  
Classification Criteria ◽  
Systemic Lupus ◽  
Scarring Alopecia ◽  
Histological Characteristics

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.

Hair disorders

2018 ◽  
Author(s):  
David de Berker
Keyword(s):  
Hair Loss ◽  
Alopecia Areata ◽  
Lupus Erythematosus ◽  
Inflammatory Diseases ◽  
Whole Body ◽  
Discoid Lupus Erythematosus ◽  
Lichen Planopilaris ◽  
Small Areas ◽  
The Family ◽  
Scalp Diseases

This chapter discusses inflammatory scalp diseases and hair shedding (telogen effluvium and pattern hair loss). Inflammatory diseases of the scalp can affect all epidermal surfaces or focus upon the follicle, with relative sparing of the interfollicular skin. Eczema and psoriasis are examples of the former; other diseases, such as lichen planopilaris or discoid lupus erythematosus, are examples of the latter. Some follicular diseases, such as the family of diseases based on alopecia areata (alopecia areata (small areas of hair loss), alopecia totalis (whole scalp), and alopecia universalis (whole body)), cause barely visible follicular inflammation which results in hair loss but no scarring. Some patients present with hair shedding or change of hair pattern as their primary complaint, with no scalp disease; this is telogen effluvium. Others present with an altered pattern of scalp hair without conspicuous shedding; this is pattern hair loss.

Alopecia areata in patients with systemic lupus erythematosus treated with belimumab: a plausible association

Lupus ◽  
2020 ◽  
Vol 29 (4) ◽  
pp. 426-430 ◽  
Author(s):  
O Shamriz ◽  
S H Yahia ◽  
Y Ramot ◽  
N Agmon-Levin ◽  
Y Tal
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Monoclonal Antibody ◽  
Hair Loss ◽  
Alopecia Areata ◽  
Lupus Erythematosus ◽  
B Lymphocyte ◽  
Systemic Lupus ◽  
Immune Mediated ◽  
B Lymphocyte Stimulator ◽  
Current Report

Belimumab, an anti-B-lymphocyte stimulator monoclonal antibody, was recently approved for the treatment of systemic lupus erythematosus. Alopecia areata is characterized by an acute immune-mediated hair loss. Herein, we report on three adult systemic lupus erythematosus patients who developed alopecia areata in association with belimumab treatment. Alopecia areata was resolved in all three patients and belimumab was discontinued in two of them. Thus, in the current report, we explore the plausible link between alopecia areata and belimumab.

Percutaneous sclerotherapy for spongiform venous malformations – analysis of patient-evaluated outcome and satisfaction

VASA ◽  
2017 ◽  
Vol 46 (6) ◽  
pp. 477-483
Author(s):  
Robert Karl Clemens ◽  
Frederic Baumann ◽  
Marc Husmann ◽  
Thomas Oleg Meier ◽  
Christoph Thalhammer ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Medical Records ◽  
Venous Malformation ◽  
Primary Treatment ◽  
Venous Malformations ◽  
Treated Area ◽  
Item Questionnaire ◽  
Percutaneous Sclerotherapy ◽  
Multiple Treatments ◽  
Pain Improvement

Abstract. Background: Congenital venous malformations are frequently treated with sclerotherapy. Primary treatment goal is to control the often size-related symptoms. Functional impairment and aesthetical aspects as well as satisfaction have rarely been evaluated. Patients and methods: Medical records of patients who underwent sclerotherapy of spongiform venous malformations were reviewed and included in this retrospective study. The outcome of sclerotherapy as self-reported by patients was assessed in a 21 item questionnaire. Results: Questionnaires were sent to 166 patients with a total of 327 procedures. Seventy-seven patients (48 %) with a total of 159 procedures (50 %) responded to the survey. Fifty-seven percent of patients were male. The age ranged from 1 to 38.1 years with a median age of 16.4 years. The lower extremities were the most common treated area. Limitations caused by the venous malformation improved in the majority of patients (e.g. pain improvement 87 %, improvement of swelling 83 %) but also worsening of symptoms occurred in a minority of cases. Seventy-seven per cent would undergo sclerotherapy again. Conclusions: Sclerotherapy for treatment of venous malformations results in significant reduction of symptoms. Multiple treatments are often needed, but patients are willing to undergo them.

scholarly journals Pattern and prevalence of neuropsychiatric lupus: a retrospective study from a tertiary level hospital in Bangladesh

2021 ◽  
Vol 57 (1) ◽  
Author(s):  
Fahima Hossain ◽  
Mohammad Delwer Hossain Hawlader ◽  
Dipak Kumar Mitra ◽  
Mohammad Hayatun Nabi ◽  
Md. Mujibur Rahman
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Retrospective Study ◽  
Cognitive Dysfunction ◽  
Lupus Erythematosus ◽  
Neuropsychiatric Symptoms ◽  
Tertiary Care ◽  
Care Hospital ◽  
Systemic Lupus ◽  
Case Definitions ◽  
American College Of Rheumatology

Abstract Background Neuropsychiatric systemic lupus erythematosus (NPSLE) is well known for its varying presentations and poor outcomes, but little is evident about its distribution and characteristics among the Bangladeshi population. This study aimed to assess the pattern and prevalence of neuropsychiatric symptoms in female systemic lupus erythematosus (SLE) patients of Bangladesh. A retrospective study was conducted at a tertiary care hospital in Dhaka, Bangladesh, between January and December 2018. One hundred female SLE patients were included in the study purposively. Data were collected on sociodemographic and clinical characteristics of diagnosed SLE cases visiting the SLE clinic and indoor medicine department. Neuropsychiatric (NP) syndromes were defined according to the widely accepted American College of Rheumatology (ACR) nomenclature and case definitions. Results A total of 244 NP events were identified in fifty-five patients. Headache was the most frequent symptom (55%), followed by cognitive dysfunction (50%), anxiety (49%), psychosis (43%), seizure (23%), depression (17%), and cerebrovascular disease (ischemic type, 7%). The NP manifestations were more prevalent among urban residents (58.2%), younger patients (41.8%), and patients with graduate-level education (34.5%). Besides, young age at diagnosis (p = 0.038), Raynaud’s phenomenon (p = 0.015), other organ involvement (p < 0.001), and time of NPSLE development (p < 0.001) were found to be significantly associated with the development of these manifestations. Conclusion NP damage is prevalent among Bangladeshi female SLE patients (55%) with headache and cognitive dysfunction being the most common symptoms. Routine screening for neuropsychiatric symptoms among suspected SLE cases and further evaluation with a larger population are warranted.

Hair Growth in a Patient with Alopecia Areata on Tocilizumab

2021 ◽  
pp. 1-5
Author(s):  
Chloe J. Walker ◽  
Kelly E. Flanagan ◽  
James T. Pathoulas ◽  
Isabel Pupo Wiss ◽  
Maryanne M. Senna
Keyword(s):  
Monoclonal Antibody ◽  
Autoimmune Disease ◽  
Hair Loss ◽  
Alopecia Areata ◽  
Interleukin 6 ◽  
Hair Growth ◽  
Posterior Uveitis ◽  
Case Presentation ◽  
Antibody Targeting ◽  
Growth Changes

<b><i>Introduction:</i></b> Tocilizumab (TCZ), a recombinant humanized antihuman monoclonal antibody targeting interleukin-6 (IL-6) signaling, is often utilized in the management of autoimmune disease. Few reports have demonstrated hair growth changes in patients on TCZ. <b><i>Case Presentation:</i></b> Herein, we review the literature and report a 21-year-old woman with progressive alopecia areata (AA) presenting with AA improvement while on TCZ for concomitant posterior uveitis. <b><i>Discussion:</i></b> Our case demonstrates the potential ability of TCZ to disrupt IL-6 signaling involved in AA, leading to hair loss and regrowth.

scholarly journals Gender Differences in Psychosocial Outcomes of Hair Loss Resulting from Childhood Irradiation for Tinea Capitis

2021 ◽  
Vol 18 (15) ◽  
pp. 7825
Author(s):  
Liat Hoffer ◽  
Netta Achdut ◽  
Shifra Shvarts ◽  
Dorit Segal-Engelchin
Keyword(s):  
Gender Differences ◽  
Hair Loss ◽  
Medical Records ◽  
Tinea Capitis ◽  
Psychosocial Outcomes ◽  
Self Esteem ◽  
Psychosocial Needs ◽  
Increased Risk ◽  
Physical Health Problems ◽  
Physical Bullying

Recent studies have linked hair loss due to childhood irradiation for tinea capitis, a fungal infection of the scalp, to adverse psychosocial and health outcomes in women. However, no study to date has examined gender differences in the outcomes of this type of hair loss. The current study aimed to investigate gender differences in health and psychosocial outcomes of hair loss resulting from childhood irradiation for tinea capitis, and to identify the risk factors associated with depression in both men and women. Medical records held at the archives of the Israel National Center for Compensation of Scalp Ringworm Victims were retrospectively reviewed for 217 women and 105 men who received maximum disability compensation due to severe hair loss resulting from irradiation for tinea capitis. We found that women were at increased risk of developing psychosocial symptoms, including depression. Gender emerged as a significant predictor of depression, distinct from other predictors, such as marital status, age at radiation, exposure to verbal and physical bullying, low self-esteem, social anxiety, and physical health problems. Thus, the psychosocial needs of patients, particularly female patients, who were irradiated for tinea capitis during childhood need to be taken into account by the healthcare professionals treating them.

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