INTRODUCTION
Alopecia is a common troubling symptom in dermatology. It can be divided into various categories and is usually classified clinically and histopathologically into scarring and non-scarring alopecia.1 It can also be subdivided based on etiology such as genetic, nutritional deficiency, endocrine, infectious, and autoimmune. There is an overlap between these categories, eg, scarring alopecia can be autoimmune, but not all autoimmune alopecias are scarring.1 The human hair follicles are immune-privileged structures, and under normal circumstances, they are protected from immune damage.2 Autoimmune-associated hair loss results whenever there is a collapse in this immune privilege. Autoimmune alopecia refers to hair loss secondary to an underlying autoimmune skin disease. This includes alopecia from lichen planopilaris (LPP), bullous diseases, and connective tissue diseases. In this paper, we focused on autoimmune connective tissue disease (ACTD)-related hair loss, and in particular non-scarring alopecia. ACTDs are a relatively rare group of multisystem diseases characterized by immune dysregulation and autoantibodies. The most common include systemic lupus erythematosus (SLE), dermatomyo¬sitis (DM), systemic sclerosis (SSc), Sjogren syndrome (SJO), undifferentiated connective tissue disease (UCTD), and mixed connective tissue disease (MCTD). They usually present with characteristic signs and symptoms. Cutaneous manifestations and hair loss are common in ACTDs. There are few studies of alopecia in ACTDs, and most of them focus on SLE and discoid lupus erythematosus (DLE). However very little is known about alopecia in other less common ACTDs. We performed this study to better understand the frequency and characteristics of non-scarring alopecia in different ACTDs.
MATERIALS AND METHODS
This study was performed to characterize non-scarring alopecia, timing relative to disease onset of hair loss in different ACTDs, to identify if these characteristics can be related to potentially different etiologies of non-scarring alopecia, and to examine the frequency with which non-scarring alopecia is evaluated and treated in ACTDs in standard vs specialty dermatology-rheumatology clinical care.
