Perales A, Lipsker D, Cribier B, Lenormand C
Clinique dermatologique, Université de Strasbourg et Hôpitaux Universitaires de Strasbourg, 1 place de l'Hôpital, 67091 Strasbourg, France.
Clinique dermatologique, Université de Strasbourg et Hôpitaux Universitaires de Strasbourg, 1 place de l'Hôpital, 67091 Strasbourg, France.
Ann Dermatol Venereol. 2023 Dec;150(4):260-269. doi: 10.1016/j.annder.2023.04.002. Epub 2023 Aug 17.
Although non-scarring alopecia (NSA) is a frequent clinical finding in patients with systemic lupus erythematosus (SLE), it has been poorly described in the literature. It is considered a nonspecific sign in the current classification of skin lesions of LE. The aim of this study was to give an updated overview of the spectrum of NSA in LE patients, with emphasis on the clinical significance thereof.
We conducted a review of the English literature using the PubMed-Medline database using the keywords "Alopecia" + "Lupus erythematosus". Publications describing LE patients with NSA were included.
Data for 237 patients from 27 publications were analyzed. Ninety-one patients had diffuse NSA, 43 had patchy NSA, 83 had lupus hair, 3 had alopecia of dermal cutaneous LE, and 17 had alopecia of linear and annular lupus panniculitis of the scalp. Patients with diffuse/patchy NSA and lupus hair shared the following features: strong association with systemic activity of LE, subtle clinical/trichoscopic signs of inflammation, histological aspect consistent with lesions specific to cutaneous LE, high likelihood of response to SLE therapy, and absence of progression to scarring alopecia. Association with SLE was rare in patients with dermal cutaneous LE or linear and annular lupus panniculitis of the scalp, and skin-directed therapies were most often effective. One patient of each subtype progressed to scarring alopecia.
Diffuse/patchy NSA and lupus hair may represent a topographic variation of a single entity specific for LE. Prospective studies are warranted to further document the clinical significance of this manifestation.
尽管非瘢痕性脱发（NSA）是系统性红斑狼疮（SLE）患者常见的临床症状，但文献中对此描述较少。在当前LE皮肤病变分类中，它被视为非特异性体征。本研究旨在对LE患者的NSA谱系进行最新概述，重点关注其临床意义。
我们使用PubMed - Medline数据库，以“脱发”+“红斑狼疮”为关键词对英文文献进行综述。纳入描述有NSA的LE患者的出版物。
分析了来自27篇出版物的237例患者的数据。91例患者有弥漫性NSA，43例有斑片状NSA，83例有狼疮发，3例有皮肤型LE脱发，17例有头皮线性和环状狼疮性脂膜炎脱发。弥漫性/斑片状NSA和狼疮发患者具有以下共同特征：与LE的全身活动密切相关、炎症的细微临床/毛发镜征象、组织学表现与皮肤型LE的特异性病变一致、对SLE治疗反应的可能性高以及无进展为瘢痕性脱发。皮肤型LE或头皮线性和环状狼疮性脂膜炎患者与SLE的关联罕见，皮肤定向治疗通常有效。各亚型均有1例患者进展为瘢痕性脱发。
弥漫性/斑片状NSA和狼疮发可能代表LE特有的单一实体的地形变异。有必要进行前瞻性研究以进一步证明这种表现的临床意义。
