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Alopecia in Systemic Autoimmune Disease

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Synonyms

Autoimmune disease and hair loss

Definition

Hair loss that is directly associated with autoimmune disease involves immune mechanisms in its pathogenesis targeting the hair follicles. They may be localized or generalized, as well as scarring and non-scarring in type. Secondary factors may also play a role in hair growth, including the medications used to treat the primary disease.

Lupus

Hair loss is one of the most common cutaneous signs of systemic lupus erythematosus (SLE) and is present in more than half the patients at some time during the course of their illness (Moghadam-Kia and Franks 2013). Alopecia can be the presenting manifestation of SLE and may affect the scalp, eyebrows, eyelashes, beard hair, or body hair (McCauliffe and Sontheimer 1996). Alopecia may be associated with active disease and can also occur due to immunosuppressive medications used to treat lupus. Lupus alopecia can be scarring associated with discoid lupus or non-scarring. The Systemic Lupus...

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References

  • Alarcon-Segovia D, Cetina JA. Lupus hair. Am J Med Sci. 1974;267(4):241–2.

    PubMed  CAS  Google Scholar 

  • Alkhalifah A, Alsantali A, Wang E, McElwee KJ, Shapiro J. Alopecia areata update: part I. Clinical picture, histopathology, and pathogenesis. J Am Acad Dermatol. 2010a;62(2):177–88.

    PubMed  CAS  Google Scholar 

  • Alkhalifah A, Alsantali A, Wang E, McElwee KJ, Shapiro J. Alopecia areata update: part II. Treatment. J Am Acad Dermatol. 2010b;62(2):191–202.

    PubMed  CAS  Google Scholar 

  • Borovicka JH, Thomas L, Prince C, Mehregan DR. Scarring alopecia: clinical and pathologic study of 54 African-American women. Int J Dermatol. 2009;48(8):840–5.

    PubMed  Google Scholar 

  • Callen JP. Dermatomyositis. Lancet. 2000;355(9197):53–7.

    PubMed  CAS  Google Scholar 

  • Callen JP, Wortmann RL. Dermatomyositis. Clin Dermatol. 2006;24(5):363–73.

    PubMed  Google Scholar 

  • Chung L, Lin J, Furst DE, Fiorentino D. Systemic and localized scleroderma. Clin Dermatol. 2006;24(5):374–92.

    PubMed  Google Scholar 

  • Crispín JC, Oukka M, Bayliss G, Cohen RA, Van Beek CA, Stillman IE, Kyttaris VC, Juang YT, Tsokos GC. Expanded double negative T cells in patients with systemic lupus erythematosus produce IL-17 and infiltrate the kidneys. J Immunol. 2008;181(12):8761–6.

    PubMed  PubMed Central  Google Scholar 

  • Dalakas MC, Hohlfeld R. Polymyositis and dermatomyositis. Lancet. 2003;362(9388):971–82.

    PubMed  CAS  Google Scholar 

  • Dawkins MA, Jorizzo JL, Walker FO, Albertson D, Sinal SH, Hinds A. Dermatomyositis: a dermatology-based case series. J Am Acad Dermatol. 1998;38(3):397–404.

    PubMed  CAS  Google Scholar 

  • Donnelly AM, Halbert AR, Rohr JB. Discoid lupus erythematosus. Australas J Dermatol. 1995;36(1):3–10; quiz 11–2. Review.

    PubMed  CAS  Google Scholar 

  • Dourmishev LA, Wollina U. Dermatomyositis: immunopathologic study of skin lesions. Acta Dermatovenerol Alp Panonica Adriat. 2006;15(1):45–51.

    Google Scholar 

  • Dutz JP, Sontheimer RD. Pathomechanisms of cutaneous lupus erythematosus. In: Wallace DJ, Hahn BH, editors. Dubos’ Lupus erythematosus. 6th ed. Philadelphia: Lippincot William & Wilkins; 2002. p. 549–71.

    Google Scholar 

  • Euwer RL, Sonthheimer RD. Dermatomyositis. In: Sontheimer RD, Provost TT, editors. Cutaneous manifestations of rheumatic disease. Baltimore: Williams and Wilkins; 1996. p. 73.

    Google Scholar 

  • Fabbri P, Amato L, Chiarini C, Moretti S, Massi D. Scarring alopecia in discoid lupus erythematosus: a clinical, histopathologic and immunopathologic study. Lupus. 2004;13(6):455–62.

    PubMed  CAS  Google Scholar 

  • Ferraz LB, Almeida FA, Vasconcellos MR, Faccina AS, Ciconelli RM, Ferraz MB. The impact of lupus erythematosus cutaneous on the Quality of life: the Brazilian-Portuguese version of DLQI. Qual Life Res. 2006;15(3):565–70.

    PubMed  CAS  Google Scholar 

  • Gilliam AC. Scleroderma. Curr Dir Autoimmun. 2008;10:258–79.

    PubMed  CAS  Google Scholar 

  • Gilliam JN, Sontheimer RD. Distinctive cutaneous subsets in the spectrum of lupus erythematosus. J Am Acad Dermatol. 1981;4(4):471–5.

    PubMed  CAS  Google Scholar 

  • Gilliam JN, Sontheimer RD. Skin manifestations of SLE. Clin Rheum Dis. 1982;8(1):207–18.

    PubMed  CAS  Google Scholar 

  • Kasteler JS, Callen JP. Scalp involvement in dermatomyositis. Often overlooked or misdiagnosed. JAMA. 1994;272(24):1939–41.

    PubMed  CAS  Google Scholar 

  • McCauliffe DP, Sontheimer RD. Cutaneous lupus erythematosus. In: Schur PH, editor. The clinical management of systemic lupus erythematosus. Secondth ed. Philadelphia: Lippincott; 1996.

    Google Scholar 

  • Moghadam-Kia S, Franks Jr AG. Autoimmune disease and hair loss. Dermatol Clin. 2013;31(1):75–91.

    PubMed  CAS  Google Scholar 

  • Moises-Alfaro C, Berrón-Pérez R, Carrasco-Daza D, Gutiérrez-Castrellón P, Ruiz-Maldonado R. Discoid lupus erythematosus in children: clinical, histopathologic, and follow-up features in 27 cases. Pediatr Dermatol. 2003;20(2):103–7.

    PubMed  Google Scholar 

  • Olsen EA, Messenger AG, Shapiro J, et al. Evaluation and treatment of male and femalepattern hair loss. J Am Acad Dermatol. 2005;52(2):301–11.

    PubMed  Google Scholar 

  • Petri M, Orbai A, Alarcón G, et al. Derivation and validation of systemic lupus international collaborating clinics classification criteria for systemic lupus erythematosus. Arthritis Rheum. 2012;64(8):2677–86.

    PubMed  PubMed Central  Google Scholar 

  • Ross EK, Tan E, Shapiro J. Update on primary cicatricial alopecias. J Am Acad Dermatol. 2005;53(1):1–37; quiz 38–40. Review. Erratum in: J Am Acad Dermatol. 2005;53(3):496.

    PubMed  Google Scholar 

  • Santmyire-Rosenberger B, Dugan EM. Skin involvement in dermatomyositis. Curr Opin Rheumatol. 2003;15(6):714–22.

    PubMed  Google Scholar 

  • Sellheyer K, Bergfeld WF. Histopathologic evaluation of alopecias. Am J Dermatopathol. 2006;28(3):236–59.

    PubMed  Google Scholar 

  • Shapiro J. Cicatricial (scarring) alopecias. In: Shapiro J, editor. Hair loss: principles of diagnosis and management of alopecia. London: Martin Duniz; 2002. p. 155–74.

    Google Scholar 

  • Sinclair R. Male pattern androgenetic alopecia. BMJ. 1998;317(7162):865–9.

    PubMed  CAS  PubMed Central  Google Scholar 

  • Sontheimer RD, McCauliffe DP. Cutaneous manifestations of lupus erythematosus. In: Wallace DJ, Hahn BH, editors. Dubos’ lupus erythematosus. 6th ed. Philadelphia: Lippincot William & Wilkins; 2002. p. 573–618.

    Google Scholar 

  • Tan E, Martinka M, Ball N, Shapiro J. Primary cicatricial alopecias: clinicopathology of 112 cases. J Am Acad Dermatol. 2004;50(1):25–32.

    PubMed  Google Scholar 

  • Tanasescu C, Balanescu E, Balanescu P, Olteanu R, Badea C, Grancea C, Vagu C, Bleotu C, Ardeleanu C, Georgescu A. IL-17 in cutaneous lupus erythematosus. Eur J Intern Med. 2010;21(3):202–7.

    PubMed  CAS  Google Scholar 

  • Tosti A, Pazzaglia M. Drug reactions affecting hair: diagnosis. Dermatol Clin. 2007;25(2):223–31.

    PubMed  CAS  Google Scholar 

  • Tymms KE, Webb J. Dermatopolymyositis and other connective tissue diseases: a review of 105 cases. J Rheumatol. 1985;12(6):1140–8.

    PubMed  CAS  Google Scholar 

  • Werth VP, White WL, Sanchez MR, Franks AG. Incidence of alopecia areata in lupus erythematosus. Arch Dermatol. 1992;128(3):368–71.

    PubMed  CAS  Google Scholar 

  • Whiting DA. Cicatricial alopecia: clinico-pathological findings and treatment. Clin Dermatol. 2001;19(2):211–25.

    PubMed  CAS  Google Scholar 

  • Yell JA, Mbuagbaw J, Burge SM. Cutaneous manifestations of systemic lupus erythematosus. Br J Dermatol. 1996;135(3):355–62.

    PubMed  CAS  Google Scholar 

  • Zhang Z, Kyttaris VC, Tsokos GC. The role of IL-23/IL-17 axis in lupus nephritis. J Immunol. 2009;183(5):3160–9.

    PubMed  CAS  PubMed Central  Google Scholar 

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Correspondence to Siamak Moghadam-Kia .

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Moghadam-Kia, S., Franks, A.G. (2014). Alopecia in Systemic Autoimmune Disease. In: Mackay, I.R., Rose, N.R., Diamond, B., Davidson, A. (eds) Encyclopedia of Medical Immunology. Springer, New York, NY. https://doi.org/10.1007/978-0-387-84828-0_232

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  • DOI: https://doi.org/10.1007/978-0-387-84828-0_232

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  • Publisher Name: Springer, New York, NY

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