• Lupus
• Lupus references

Lupus

Systemic lupus erythematosus (SLE or lupus) is a rare chronic disease manifested by inflammation of multiple organ systems including the joints, skin, kidneys, heart, lungs, blood vessels and brain. The ratio of women to men affected is around 10:1 . While the cause of lupus remains unknown, blood test abnormalities tend to implicate an autoimmune mechanism where antibodies are produced against one's own cells and tissues. Unlike alopecia areata, where antibodies are found specific for components within the hair follicle, the characteristic laboratory finding in lupus is the presence of antibody to our basic genetic material, DNA, and other substances found within the nuclei of all cell types in the body. In addition to these antinuclear antibodies (ANA), there may be antibodies to blood cells and various proteins present in the blood circulatory system.

Skin rashes appear in the majority of patients. The classic manifestation is a pink, butterfly-shaped eruption over the nose and cheeks that is aggravated by sun exposure. A similar rash, bruising, hives, blisters or ulcers may be present in other areas. In association, there may be diffuse hair loss as a result of the generalized immune response throughout the body. Hair loss can temporarily recover or it may wax and wane with changes in disease severity, but in many cases the hair loss becomes permanent as a result of scarring. The hair loss is associated with a heavy infiltrate of immune cells in the skin. As with many autoimmune diseases there may be spontaneous remission for some people.

Treatment may involve the use of corticosteroids or other immunosuppressants. In some cases hair transplants may be used to cover small patches of scarring alopecia resulting from chronic discoid lupus erythematosus.

Lupus references

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• Annessi G, Lombardo G, Gobello T, Puddu P. A clinicopathologic study of scarring alopecia due to lichen planus: comparison with scarring alopecia in discoid lupus erythematosus and pseudopelade. Am J Dermatopathol. 1999 Aug;21(4):324-31.
• Mok CC, Lau CS, Chan TM, Wong RW. Clinical characteristics and outcome of southern Chinese males with systemic lupus erythematosus. Lupus. 1999;8(3):188-96.
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