Department of Diabetes, Endocrinology and Clinical Immunology, Hyogo Medical University School of Medicine, Nishinomiya, Hyogo, Japan.
Department of Dermatology, Hyogo Medical University School of Medicine, Nishinomiya, Hyogo, Japan.
Mod Rheumatol Case Rep. 2024 Jul 8;8(2):267-271. doi: 10.1093/mrcr/rxae018.
Alopecia associated with lupus erythematosus is broadly classified into reversible nonscarring alopecia seen in the acute phase, such as worsening of systemic lupus erythematosus (SLE) and cicatricial alopecia seen in chronic cutaneous lupus erythematosus represented by discoid lupus erythematosus (DLE). In DLE-induced alopecia, early therapeutic intervention before developing scarring alopecia is important, but the condition is often resistant to conventional treatment. Anifrolumab (ANI), a novel therapeutic agent for SLE that inhibits Type I interferon activity, has been shown to be effective against acute skin lesions, including alopecia, in patients with SLE. However, there are very few reports on the effect of ANI on alopecia due to DLE. We report on a 27-year-old Japanese woman with SLE whose alopecia due to chronic DLE was refractory to topical therapy and systemic therapy with oral glucocorticoid, multiple immunosuppressants, and belimumab for ∼8 years after onset and whose alopecia improved with ANI. ANI can be considered to be an effective treatment option in lupus patients presenting with alopecia due to DLE, even in the chronic refractory stage.
红斑狼疮相关的脱发可大致分为急性阶段出现的可逆性非瘢痕性脱发，如系统性红斑狼疮（SLE）恶化，以及慢性皮肤红斑狼疮（如盘状红斑狼疮（DLE））表现出的瘢痕性脱发。在 DLE 引起的脱发中，在发生瘢痕性脱发之前进行早期治疗干预很重要，但这种情况通常对常规治疗有抗性。阿尼鲁单抗（ANI）是一种新型治疗 SLE 的药物，可抑制 I 型干扰素活性，已被证明对 SLE 患者的急性皮肤病变（包括脱发）有效。然而，关于 ANI 对 DLE 引起的脱发的疗效的报告非常少。我们报告了一位 27 岁的日本女性，她患有 SLE，慢性 DLE 引起的脱发对局部治疗和口服糖皮质激素、多种免疫抑制剂以及贝利尤单抗联合治疗有抗性，这些治疗在发病后约 8 年仍未起效，而用 ANI 治疗后脱发得到改善。ANI 可被视为 DLE 引起的狼疮脱发患者的有效治疗选择，即使在慢性难治阶段也如此。
