Non-lupus alopecias such as telogen effluvium and anagen effluvium have a myriad of causes which include disease flares, drugs and stress in the setting of LE. Lupus hair in SLE is a poorly characterised entity and may be a form of telogen effluvium. 47.Īlopecias which show histological characteristics of LE are LE-specific, and include discoid LE (DLE), diffuse or patchy hair loss in acute LE, subacute cutaneous LE, and rarely tumid LE. 54 In contrast to DLE, there is no interface dermatitis and follicular plugging, and DIF is negative.
14 47 A retrospective review has recently shown that the presence of a peripilar white grey halo surrounding the emerging hairs on dermoscopy is highly specific and sensitive for CCCA. 27 34 A frequently cited distinguishing histopathological feature of CCCA is the premature desquamation of the inner root sheath. 14 27 The pathogenesis is poorly understood, but is usually a combination of genetics and certain traumatic hair care practices. 14 47 A burning, tender or itching sensation is commonly felt on the active sites.
14 27 34 47 The non-inflammatory centre of the plaque has increased interfollicular spacing due to a mixture of tufted and normal-appearing hairs. The presentation of alopeciahypotrichosis may be localized or generalized and focal, patchy or diffuse, depending on disease severity, duration, and the cause of the hair loss.Īlopecia not associated with trauma may be due to an inflammatory condition, such as pyoderma, follicular demodicosis, dermatophytosis, or sebaceous adenitis.Ī minimum dermatology database consisting of skin scrapings, fungal culture, and surface cytology should be performed on all cases of alopecia.Ī list of treatment options for some of the inflammationinduced causes of alopecia is presented.Īlopecia in itself is seldom a lifethreatening condition although, in some instances, it may be a cutaneous marker for a systemic disease that could carry a guarded to grave prognosis.Ĭentral centrifugal cicatricial alopecia The classic presentation of central centrifugal cicatricial alopecia (CCCA) is a centrifugally expanding area of scleroatrophic alopecia on the crown or vertex most commonly seen among middle-aged AfricanAmerican women.
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