INTRODUCTION
Cutaneous lupus erythematosus (CLE), a group of autoimmune skin diseases characterized by skin eruptions including, but not limited to photosensitivity, malar rash, discoid lupus erythematosus (DLE), and subacute cutaneous lupus erythematosus (SCLE), as well as generalized non-scarring alopecia, which manifests in up to 85% of systemic lupus erythematosus (SLE) patients.1
SLE diagnostic criteria, as established by prominent health organizations like the Systemic Lupus International Collaborating Clinics (SLICC), European League Against Rheumatism (EULAR), and American College of Rheumatology (ACR), incorporate non-scarring alopecia, potentially complicating the differential diagnosis for patients with both SLE and hair loss.2,3 Differentiating between solely alopecia areata (AA), AA concomitant in the setting of SLE, or other conditions initially resembling AA, such as DLE or syphilitic alopecia, may present a clinical challenge, necessitating comprehensive patient history and diagnostic tools.4-6
This article illuminates the need for a multidisciplinary approach in managing CLE-associated alopecia and patchy AA through the examination of two case studies. With an emphasis on diagnosis and treatment, this study accentuates the critical importance of a comprehensive understanding of these conditions, collaboration among healthcare professionals, and ongoing research to refine treatment strategies and ultimately improve patient outcomes.
Case 1
A 36-year-old Asian male with a 22-year history of Systemic Lupus Erythematosus (SLE) presented to a dermatology clinic in 2016, reporting rapid hair loss and intense headaches (Figures 1 and 2). His SLE history included Discoid Lupus Erythematosus
SLE diagnostic criteria, as established by prominent health organizations like the Systemic Lupus International Collaborating Clinics (SLICC), European League Against Rheumatism (EULAR), and American College of Rheumatology (ACR), incorporate non-scarring alopecia, potentially complicating the differential diagnosis for patients with both SLE and hair loss.2,3 Differentiating between solely alopecia areata (AA), AA concomitant in the setting of SLE, or other conditions initially resembling AA, such as DLE or syphilitic alopecia, may present a clinical challenge, necessitating comprehensive patient history and diagnostic tools.4-6
This article illuminates the need for a multidisciplinary approach in managing CLE-associated alopecia and patchy AA through the examination of two case studies. With an emphasis on diagnosis and treatment, this study accentuates the critical importance of a comprehensive understanding of these conditions, collaboration among healthcare professionals, and ongoing research to refine treatment strategies and ultimately improve patient outcomes.
Case 1
A 36-year-old Asian male with a 22-year history of Systemic Lupus Erythematosus (SLE) presented to a dermatology clinic in 2016, reporting rapid hair loss and intense headaches (Figures 1 and 2). His SLE history included Discoid Lupus Erythematosus
