Extensive scarring alopecia and widespread rash (original) (raw)

Treatment of Scarring Alopecia in Discoid Variant of Chronic Cutaneous Lupus Erythematosus With Tacrolimus Lotion, 0.3

JAMA dermatology, 2015

Discoid lupus erythematosus (DLE) is a chronic variant of cutaneous lupus erythematosus, an autoimmune inflammatory disorder of the skin. Lesions are often localized to the scalp and can result in permanent scarring, disfiguration, and irreversible alopecia. Although DLE usually responds to topical or intralesional corticosteroids and/or oral antimalarials, some DLE is resistant to these treatments or adverse effects limit their effectiveness. Three patients with treatment-refractory, biopsy-proved DLE were prescribed a novel, off-label preparation of tacrolimus lotion, 0.3%, in an alcohol base as an adjunct to oral antimalarial therapy. All 3 patients demonstrated improvement in lesion severity and hair regrowth with the use of this regimen after 3 months and continued improvement thereafter. We report a retrospective analysis of these 3 cases. This report is, to our knowledge, the first mention of tacrolimus being used in a lotion formulation to treat DLE lesions, resulting in hai...

Specific cutaneous histologic and immunologic features in a case of early lupus erythematosus scarring alopecia

Our Dermatology Online, 2013

Introduction:Immunoreactants detected by direct immunofluorescence (DIF) in the skin of patients with lupus erythematosus represent an important tool in the diagnosis of this disorder. Case report: A 46 year old African American female presented complaining of hair loss and scarring in her scalp. Methods: Biopsies for hematoxylin and eosin (H&E) examination, as well as for direct immunofluorescence (DIF) were performed. Results: The histologic features were representative of early lupus erythematosus. DIF demonstrated immune deposits of several immunoglobulins and complement, primarily around skin appendageal structures(hair follicles and sweat glands). Deposits of immunoglobulin D were seen in several areas of the epidermis. Conclusion: In lupus erythematosus, evaluation of immune reactions against cutaneous appendageal structures may be crucial in differentiating this disorder from other autoimmune and non-autoimmune diseases.

Systemic lupus erythematosus in patients diagnosed with treatment-resistant acne

International journal of dermatology, 1995

Systemic lupus erythematosus (SLE) may involve any number of organ systems and varies greatly in the severity and type of involvement. Cutaneous manifestations of SLE are equally numerous and varied throughout the course of the disease within an individual, as well as varying between patients. Cutaneous manifestations of SLE are frequently the presenting symptoms, typically noted in the classic malar "butterfly" rash; however, other cutaneous patterns are frequently observed. We present here two patients who presented with what was thought to be acne refractory to treatment. These patients actually were found to have a facial eruption associated with SLE as confirmed by skin biopsy. The importance of investigating atypical or treatment-resistant eruptions, especially in patients experiencing other symptoms, is emphasized.

Prevalence of usual and unusual skin manifestations of systemic lupus erythematosus in a tertiary care hospital

2016

Objective To determine prevalence of different types of skin manifestations in SLE in our country. Methods The study was carried out at the Rheumatology and Immunology Department, Shaikh Zayed Hospital, Lahore. 125 patients who were diagnosed with SLE on basis of American College of Rheumatology classification criteria for SLE and also having skin manifestations were included from June 2011 till June 2015 from outdoor and inpatient departments. Results SLE specific skin manifestations were as follows: malar rash was seen in 83 (71.6%) patients, photosensitivity in 61 (49.12%) patients, oral ulcers in 39 (31.35%), maculopapular rashes in 29 (23.46%), discoid rash in 26 (20.7%), subacute cutaneous lupus erythematosus (SCLE) in 6 (5.18%) patients. The SLE non-specific skin manifestations included: vasculitic rash in 50 (40.0%), non-scarring alopecia in 39 (30.9%), palmar erythema in 26 (21.1%), vasculitic ulcers in 7 (4.9%), livedo reticularis in 5 (3.8%), digital gangrene in 3 (2.7%),...

Padrão dermatoscópico das alopecias cicatriciais causadas por lúpus eritematoso discoide e líquen plano pilar

Anais Brasileiros de Dermatologia, 2010

FUNDAMENTOS: A dermatoscopia é método importante de diagnóstico de doenças melanocíticas benignas e malignas. Recentemente, o uso desse método tem demonstrado grande ajuda também no diagnóstico e acompanhamento das alopecias. OBJETIVO: Descrever e demonstrar os achados dermatoscópicos de pacientes com quadros clínicos e histopatológicos de alopecia cicatricial. MÉTODOS: Estudo transversal descritivo em que foram selecionados, pelos achados clínicos e histopatológicos do couro cabeludo, 14 pacientes com alopecia cicatricial, sendo quatro casos de líquen plano pilar clássico, cinco casos de alopecia fibrosante frontal e cinco com lúpus eritematoso discoide. Os pacientes foram avaliados com videodermatoscópio e dermatoscópio manual por três examinadores diferentes, de forma independente. Os aumentos variaram de 10 a 70 vezes. RESULTADOS: Foram achados predominantes no lúpus eritematoso discoide placas brancas, capilares arboriformes, tampões ceratósicos e áreas com diminuição dos óstio...

Disease severity and prophylactic measures in patients with cutaneous lupus erythematosus: results of a worldwide questionnaire-based study

Postepy dermatologii i alergologii, 2018

Due to a wide array of dermatologic manifestations, assessment of disease severity in cutaneous lupus erythematosus (CLE) remains challenging. Given a need for some standardization in this field, we conducted a worldwide questionnaire-based study among physicians experienced in CLE management. We asked about CLE assessment, their prophylactic measures advised to patients, and treatment recommendations. A total of 83 completed questionnaires were received. Participating physicians recommended assessing disease severity at each patient's visit (39.1%), monthly (4.9%) or at least every third month (17.3%). Almost half of the responding physicians (47.0%) waited 2-3 months before identifying a specific treatment option as not effective. The vast part of the participants informed their patients about of the risks of sun exposure and advised adequate preventive measures. Smoking was less frequently a matter of discussion between physicians and their patients. Recommendations for the t...