10.5826/dpc.1401a33
text/xml
2160-9381
3610
en
Hua-Ching Chang
https://creativecommons.org/licenses/by-nc/4.0
Dermatology Practical & Conceptual
Lupus Panniculitis With Linear Hair Loss on the Scalp
Text.Serial.Journal
https://dpcj.org/index.php/dpc
Image Letter
2024-01-31
2023-06-15
2024-01-31
2024-02-21
e2024033
Dermatol Pract Concept
Hua-Ching Chang
2024/01/31
10.5826/dpc.1401a33
e2024033
Department of Dermatology, Taipei Medical University Hospital; Research Center of Big Data and Meta-Analysis, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
2160-9381
en
e2024033
Udompanich S, Chanprapaph K, Suchonwanit P. Linear and Annular Lupus Panniculitis of the Scalp: Case Report with Emphasis on Trichoscopic Findings and Review of the Literature. Case Rep Dermatol. 2019; 11: 157-65.
Lupus Panniculitis With Linear Hair Loss on the Scalp
https://dpcj.org/index.php/dpc/article/download/3610/2548
                 Lupus Panniculitis With Linear Hair Loss
                              on the Scalp
                 Yu-Ju Chou1, Po-Huan Ko1, Kuo-Hsien Wang1, Hua-Ching Chang1,2,3


1 Department of Dermatology, Taipei Medical University Hospital, Taipei, Taiwan
2 Department of Dermatology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
3 Research Center of Big Data and Meta-Analysis, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan



Citation: Chou YJ, Ko PH, Wang KH, Chang HC. Lupus Panniculitis With Linear Hair Loss on the Scalp. Dermatol Pract Concept.
2024;14(1):e2024033. DOI: https://doi.org/10.5826/dpc.1401a33
Accepted: July 15, 2023; Published: January 2024
Copyright: ©2024 Chou et al. This is an open-access article distributed under the terms of the Creative Commons Attribution-
NonCommercial License (BY-NC-4.0), https://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted noncommercial use,
distribution, and reproduction in any medium, provided the original authors and source are credited.
Funding: None.
Competing Interests: None.
Authorship: All authors have contributed significantly to this publication.
Corresponding Author: Hua-Ching Chang, Department of Dermatology, Taipei Medical University Hospital, No. 252, Wuxing St,
Xinyi District, Taipei City, 110, Taiwan. Tel: 886-2-27372181 ext 8285; E-mail: b101095089@tmu.edu.tw




Case Presentation                                                        Teaching Point
A 30-year-old Asian healthy man presented with 1.5 years of              Linear lupus erythematosus panniculitis of the scalp is a
asymptomatic progressive linear hair loss, which was 20 cm               rare manifestation of cutaneous lupus erythematosus [1,2].
in length and 1.5 cm in width along the right frontal, left              The mean age of onset is between 20 and 30 years of
parietal, and left occipital scalp (Figure 1, A-D). Histopa-             age, and no specific sex predominance has been noted.
thology from an incisional biopsy on the left parietal scalp             Most reported patients are of Asian ethnicity. The dis-
revealed heavy lympho-histiocytic infiltrates over superficial           ease can affect all regions of the scalp, but the parietal
and deep perivascular, peri-eccrine, and perifollicular areas,           scalp is the most commonly affected site [1]. The pro-
and lobular subcutaneous fat necrosis (Figure 1, E-F). Alcian            posed mechanism for the linear distribution of hair loss
blue stain revealed increased mucin deposition extending                 is attributed to genetically programmed clones of cells
from the dermis to the subcutaneous tissue (Figure 1G). The              along Blaschko’s lines from early embryogenesis [2]. A
                                                                  +
infiltrative cells in the dermis consisted mainly of CD4 T               ­hydroxychloroquine-containing regimen is the main treat-
lymphocytes and CD123, the plasmacytoid dendritic cell                   ment applied in previously reported cases, and improve-
marker, was also positive. Although no direct immunofluo-                ment could be achieved in approximately 60% of cases in
rescence was done, the serum antinuclear antibody was neg-               a mean duration of 8 weeks [1,2].
ative. These findings were consistent with lupus panniculitis.




Image Letter | Dermatol Pract Concept. 2024;14(1):e2024033                                                                          1
                   Figure 1. Linear nonscarring alopecia along the right frontal scalp, left parietal scalp (A), and left
                   occipital scalp (B,C). (D) One erythematous indurated plaque extending from the frontal hairline on
                   right forehead. A skin incisional biopsy showed perifollicular and perieccrine lympho-histiocytic in-
                   flammation in the dermis (E; H&E, 50X) with subcutaneous fat necrosis (F; H&E, 250X). I­ ncreased
                   mucin deposition in the dermis and subcutaneous fat (G; Alcian blue staining, 50X). Scale bar:
                   100 or 500 μm as indicated in the figures.


References                                                               2. Udompanich S, Chanprapaph K, Suchonwanit P. Linear and An-
                                                                            nular Lupus Panniculitis of the Scalp: Case Report with Empha-
1. Lueangarun S, Subpayasarn U, Tempark T. Distinctive lupus                sis on Trichoscopic Findings and Review of the Literature. Case
   panniculitis of scalp with linear alopecia along Blaschko’s lines:       Rep Dermatol. 2019;11(2):157-165. DOI: 10.1159/000500848.
   a review of the literature. Int J Dermatol. 2019;58(2):144-150.          PMID: 31543767. PMCID: PMC6738250.
   DOI: 10.1111/ijd.14155. PMID: 30074627.




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