University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Dermatol Clin. 2013 Jan;31(1):75-91. doi: 10.1016/j.det.2012.08.008. Epub 2012 Oct 26.
Once systemic disease is in remission, it is prudent to recognize the importance of alopecia in the patient's overall sense of well-being and quality-of-life clinical outcome. Scarring alopecia (scalp discoid lupus erythematosus) can be the presenting manifestation of lupus in more than half of affected individuals. Diffuse nonscarring alopecia in lupus is usually responsive to treatment of the systemic disease. Severe, often intractable burning pruritus of the scalp is a frequent complaint in dermatomyositis. Lichen planopilaris may mimic other autoimmune forms of scarring alopecia. Alopecia can also be caused by medications used to treat systemic autoimmune disease and fibromyalgia.
一旦全身性疾病得到缓解，就应该认识到脱发对患者整体健康和生活质量临床结果的重要性。瘢痕性脱发（头皮盘状红斑狼疮）在半数以上受累个体中可能是狼疮的首发表现。狼疮弥漫性非瘢痕性脱发通常对系统性疾病的治疗有反应。头皮剧烈、常为难治性瘙痒是皮肌炎的常见主诉。扁平苔藓样瘢痕性脱发可能模仿其他自身免疫性瘢痕性脱发。脱发也可由用于治疗系统性自身免疫性疾病和纤维肌痛的药物引起。
