Alopecia (Baldness)

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Lupus Erythematosus

Overview

Alopecia is one of many symptoms of lupus, an autoimmune disease. Not all people with lupus develop alopecia, and the pattern and severity depend on whether the disease is systemic or discoid.

Lupus affects more women than men and is more common among African American women than Latina, Asian, Native American, and Caucasian women.

Systemic lupus erythematosus (SLE), an inflammatory connective tissue disorder, can affect the joints, kidneys, skin, heart, lungs, blood vessels, and brain. About 20% of patients with this disorder have diffuse, nonscarring alopecia.

Discoid lupus erythematosus (DLE) causes raised, red rashes that become thick and scaly on the face, scalp, and other parts of the body. The rash can last days or years. DLE can cause oval patches of scarring alopecia.

Treatment

Treatment should begin early to avoid permanent scarring and may involve the following:

• Antimalarial medications (e.g., hydroxychloroquine), in severe cases, for months or years
• Injections of corticosteroids for difficult-to-treat lesions
• Patients should avoid the sun and other forms of ultraviolet light and should use sunscreen
• Topical corticosteroid ointments or creams for smaller lesions (excessive use should be avoided) and plastic tape coated with flurandrenolide (a corticosteroid) can sometimes be helpful

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