I got systemic lupus erythematosus, a lot of hair loss!

It is only for medical professionals to read for reference.
Why is hair loss so serious? The heart of beauty, the common systemic lupus erythematosus (SLE) patient is no exception.
Every morning, I would like to comb my thick hair like this~ ↓but the reality is like this ↓ a lot of hair is combed .
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A lot of hair is washed away.
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a lot of hair is grabbed.
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one after another.
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same hair loss, but very different types.
I believe that many SLE patients are deeply troubled by the above hair loss problem.
Now, don’t panic first, and listen to the editor slowly explain ~ We all know that SLE is an autoimmune disease involving multiple organs.
Its clinical manifestations are complex and diverse, and the skin is one of its most commonly affected organs
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Hair loss is a common skin damage in SLE patients, and is related to the activity of the disease, which seriously affects the patient's psychological state and quality of life
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Hair loss in SLE patients mostly occurs during the active stage of the disease, and can also appear as the first symptom, with an incidence of about 17.
3%-54%
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Although it is the same hair loss, its types and pathogenesis are different.
The following editor will introduce some common types of SLE hair loss, see what kind of condition your hair loss belongs to? 1.
Clinical manifestations of lupus hair: SLE is a type of non-scarring hair loss, often manifested as hairline receding, dry and dull hair, increased brittleness and easy to break, hair shortened, uneven, front forehead and top hair More obvious
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Lupus hair may be caused by negative nitrogen balance affecting normal hair growth, or because it is located on the forehead hairline and is related to facial rashes and photosensitivity
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This type of hair loss in SLE patients may indicate disease activity or worsening
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Lupus hair 2.
Clinical manifestations of SLE patchy alopecia: a non-scarring alopecia similar to alopecia areata, manifested as one or several, complete or incomplete alopecia spots, the scalp may be pale red or with mild erythema, and the hair follicle mouth is preserved Good, some patients may have mild itching or pain
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Different from alopecia areata, scattered hair growth can be seen in the alopecia spots, not smooth hair loss areas
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Patchy alopecia 3.
Clinical manifestations of diffuse telogen alopecia: progressive, non-scarring, diffuse thinning and thinning of hair
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The daily hair loss of patients is more than 120-400, and a small number of patients can accumulate more than 50% of the hair
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The appearance of the scalp is generally normal, with hair follicle openings and short vellus hair growth
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Diffuse telogen alopecia can be secondary to various stimuli (such as fever), not only in patients with mild SLE, but also in active disease or during treatment with glucocorticoids and cytotoxic drugs
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Diffuse telogen alopecia 4.
Discoid lupus erythematosus (DLE) alopecia clinical manifestations: more common in patients with SLE transformed from disseminated DLE, belonging to a typical primary cicatricial alopecia
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The skin lesions are characterized by round or disc-shaped erythema, plaques or papules with clear borders.
There are adhesive scales of telangiectasia on the surface.
The peeled scales can show that there are hair follicle openings and carpet nail-like horn plugs underneath
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In the later stage, the center of the skin lesion showed atrophy and hypopigmentation with hair loss, and the surrounding pigmentation was more active in the center of the skin lesion
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It is currently believed that DLE-type alopecia may be caused by ultraviolet radiation to cause keratinocyte apoptosis and activate the immune response mediated by T cells or immune complexes, thereby causing the destruction of hair follicles by inflammatory cells
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DLE type alopecia has so much hair loss, is SLE's condition worsened? SLE patients with hair loss are more likely to have skin damage, Raynaud’s phenomenon and muscle tenderness than those without hair loss.
These symptoms are related to the degree of hair loss, but they have nothing to do with specific indicators of the deterioration of various diseases
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According to relevant research reports, hair loss in SLE patients is positively correlated with disease activity index, and it is also one of the non-specific indicators of SLE recurrence prediction
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Therefore, once there is a sudden increase in hair loss within a certain period of time, SLE patients should pay attention to it and go to the dermatology or rheumatology department in time
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Once everything is gone, how can I treat it? At present, the treatment of SLE hair loss is mainly aimed at the treatment of SLE disease itself, and appropriate supplementary drugs are used to promote hair growth
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Patients with non-scarring alopecia: non-steroidal anti-inflammatory drugs, chloroquine or hydroxychloroquine can be used for treatment.
If the above drugs are not well treated, medium and small doses of prednisone can be given.
After the hair is regenerated, the hormones can be gradually reduced to maintainTreatment
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Patients with DLE alopecia: local topical strong glucocorticoids, intralesional injection of triamcinolone acetonide, oral antimalarials or tretinoin
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★ Prognosis: After systemic treatment, when the condition of SLE is relieved, non-scarring hair loss areas will develop and the patient has a good prognosis
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If SLE patients have SLE-type scarring alopecia, the late stage is permanent alopecia, but if treated as early as possible, some hair can be regenerated
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Daily hair care tips ① SLE patients should pay attention to rest, exercise moderately, avoid fatigue, and ensure sleep, which can help relieve stress, improve self-immunity, and promote normal skin and hair metabolism
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②Because ultraviolet radiation can aggravate the condition of SLE, especially in patients with DLE alopecia, care should be taken to avoid direct sunlight
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③Keep your hair clean.
The shampoo should not be too hot.
It is best to choose a neutral or weakly acidic shampoo that does not irritate the scalp and hair.
It is recommended that patients with SLE avoid perming or dyeing their hair
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④ proper diet, avoid spicy greasy food, eat more foods rich in vitamins and protein, such as eggs, milk, soy products, fresh vegetables and fruits
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References: [1] Ye Yanting, Zhang Xingqi.
Research progress in alopecia of systemic lupus erythematosus[J].
International Journal of Dermatovenereology.
2011,37(5):283-285.
[2]Josef SSC,Victoria PW.
Alopecias in lupus erythematosus[J].
Lupus Sci Med.
2018; 5(1): e000291.