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Scarring alopecia in chronic cutaneous lupus erythematosus with neutrophils: A new scenario with therapeutic connotations
Author(s) -
FernandezFlores Angel,
HermosaGelbard Angela,
Pérez Alberto,
Bello José Antonio,
Cabo Fernando
Publication year - 2020
Publication title -
journal of cutaneous pathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 75
eISSN - 1600-0560
pISSN - 0303-6987
DOI - 10.1111/cup.13764
Subject(s) - medicine , dapsone , context (archaeology) , dermatology , lupus erythematosus , scarring alopecia , biopsy , cutaneous lupus erythematosus , pathology , immunology , antibody , biology , paleontology , scalp
The relationship between autoinflammatory and autoimmune conditions has been demonstrated in recent decades. Several autoimmune conditions exhibit an autoinflammatory component, which can manifest in various ways. Neutrophilic dermatosis in the context of lupus erythematosus (LE) is one example. Otherwise, neutrophils are rare in LE, except for the bullous variant and nonbullous neutrophilic LE. In this paper, we describe a case of scarring alopecia due to LE that stopped responding to a treatment that had been effective for years. The biopsy specimen demonstrated the presence of neutrophils in the inflammatory infiltrate. A treatment with dapsone was prescribed and yielded rapid improvement. This first case of scarring alopecia in the context of nonbullous neutrophilic LE emphasizes the importance of the infiltrate in determining the optimal therapeutic choice.