J Rheum Dis.  2011 Jun;18(2):129-131.

A Case of Lupus Panniculitis-Misdiagnosed as Alopecia Areata

• Park MK
• Kim HK
• Park KY
• Li KS
• Seo SJ
• Hong CK

Abstract

We present a 24-year-old woman with systemic lupus erythematosus presented with multiple patches of non-scarring alopecia closely resembling alopecia areata. Scalp biopsy showed a predominantly subcutaneous and dermal lymphocytic infiltrate that surrounded the deep follicular segments and hair bulb. This pattern is capable of producing a temporary hair loss, clinically misdiagnosed as alopecia areata. The clinical history, presence of erythema on bald patches and scalp tenderness as well as the biopsy findings were important clues in diagnosis of lupus erythematosus. We report here a case of lupus panniculitis that presented as multiple bald patches misdiagnosed as alopecia areata.

Keyword

Alopecia areata; Lupus panniculitis; Subcutaneous lupus erythematosus

MeSH Terms

Alopecia
Alopecia Areata
Biopsy
Erythema
Female
Hair
Humans
Lupus Erythematosus, Systemic
Panniculitis, Lupus Erythematosus
Scalp
Young Adult

Figure

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  Figure 1. Multiple, erythematous confluent bald patches on the occipital area.

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  Figure 2. Patch were associated faint erythema but there was no evidence of scarring and the follicular orifices appeared intact.

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  Figure 3. (A) Perivascular and periappendageal patchy lymphocytic infiltration in the dermis (H&E, ×100). (B) Hyalinization of fat lobules & fat necrosis, lobular infiltration of inflammatory cells and the thickening of septa in subcutaneous tissue (H&E, ×100).

Reference

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