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

Cleide Garbelini-Lima; Gabriela Evangelista de Almeida; Sidharta  Quércia Gadelha; Andrea Cavalcante de Souza; Mara Lúcia  Gomes de Souza; Virginia  Vilasboas Figueiras

doi:10.29021/spdv.79.2.1283

Cleide Garbelini-Lima Tropical Medicine Foundation Doutor Heitor Vieira Dourado, Manaus, Amazonas, Brazil https://orcid.org/0000-0002-8840-7635
Gabriela Evangelista de Almeida Tropical Medicine Foundation Doutor Heitor Vieira Dourado, Manaus, Amazonas, Brazil https://orcid.org/0000-0002-5254-6334
Sidharta Quércia Gadelha Tropical Medicine Foundation Doutor Heitor Vieira Dourado, Manaus, Amazonas, Brazil https://orcid.org/0000-0002-1491-401X
Andrea Cavalcante de Souza Tropical Medicine Foundation Doutor Heitor Vieira Dourado, Manaus, Amazonas, Brazil https://orcid.org/0000-0002-7703-4562
Mara Lúcia Gomes de Souza Tropical Medicine Foundation Doutor Heitor Vieira Dourado, Manaus, Amazonas, Brazil https://orcid.org/0000-0002-4273-2678
Virginia Vilasboas Figueiras Tropical Medicine Foundation Doutor Heitor Vieira Dourado, Manaus, Amazonas, Brazil https://orcid.org/0000-0003-1960-5328

DOI: https://doi.org/10.29021/spdv.79.2.1283

Keywords: Alopecia, Lupus Erythematosus, Discoid/complications, Lupus Erythematosus, Systemic/complications, Scalp Dermatoses/diagnosis, Scalp Dermatoses/drug therapy, Thalidomide

Abstract

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.

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References

Hordinsky M. Cicatricial alopecia: discoid lupus erythematosus. Dermatol Ther. 2008;21:245-8. doi: 10.1111/j.1529-8019.2008.00205.x.

Concha JSS, Werth VP. Alopecias in lupus erythematosus. Lupus Sci Med. 2018;5:e000291. doi: 10.1136/lupus-2018-000291.

Chung HJ, Goldberg LJ. Histologic features of chronic cutaneous lupus erythematosus of the scalp using horizontal sectioning: Emphasis on follicular findings. J Am Acad Dermatol. 2017;77:349-55. doi: 10.1016/j.jaad.2017.02.039.

Hassan I, Dorjay K, Anwar P. Thalidomide in dermatology: revisited. Indian J Dermatol. 2015;60:213. doi: 10.4103/0019-5154.152580.

Udompanich S, Chanprapaph K, Suchonwanit P. Hair and scalp changes in cutaneous and systemic lupus erythematosus. Am J Clin Dermatol. 2018;19:679-94. doi: 10.1007/s40257-018-0363-8.

Amarante CF, Acedo LM, Rabay FM, Campos BE, Lira ML, Mandelbaum SH. Drug-induced lupus with leukocytoclastic vasculitis: a rare expression associated with adalimumab. An Bras Dermatol. 2015;90:121-4. doi: 10.1590/abd1806-4841.20153834.