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Victoria P. Werth, MD; Wain L. White, MD; Miguel R. Sanchez, MD; Andrew G. Franks, MD

Arch Dermatol. 1992;128(3):368-371.

Abstract
• Background.—
A small percentage of patients with alopecia areata have connective diseases such as systemic lupus erythematosus, discoid lupus erythematosus, rheumatoid arthritis, and scleroderma. Lupus erythematosus is associated with a number of different types of alopecia, but the incidence of alopecia areata in lupus erythematosus has not been examined.

Observations.—
Of our cohort of 39 patients with lupus erythematosus, alopecia areata developed in 10% (four patients), in contrast to 0.42% of general dermatologic patients. Biopsy specimens of alopecia areata lesions in each of our patients showed continuous granular deposition of IgG at the dermoepidermal junction, a finding usually found in only a minority of alopecia areata cases. Intralesional injections of corticosteroids were effective treatment.

Conclusions.—
The incidence of alopecia areata in patients with lupus erythematosus is increased. Recognition of this form of alopecia allows for specific therapy with intralesional corticosteroids.

(Arch Dermatol. 1992;128:368-371)

Author Affiliations
From the Department of Dermatology, University of Pennsylvania, Philadelphia (Dr Werth); Department of Pathology and Dermatology, Bowman Gray School of Medicine, Winston-Salem, NC (Dr White); and Department of Dermatology, New York (NY) University (Drs Sanchez and Franks).

Footnotes
Accepted for publication July 29, 1991.

Reprint requests to Department of Dermatology, University of Pennsylvania, Philadelphia, PA 19104 (Dr Werth).

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