Management of Alopecia and Onychomycosis in a Lupus Patient

The array of potential differential diagnoses of cutaneous lupus erythematosus (CLE) is extensive. Exclusion of infection is paramount, given the patient’s immunodeficient state. We report the case of a 33-year-old female patient who presented with pruritic erythematous papules across her upper extr...

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Bibliographic Details
Main Authors: Muzayyana Sakiinah, Awalia, Willy Sandhika, Stefanus Gunawan Kandinata, Katsuya Suzuki
Format: Article
Language:English
Published: Wolters Kluwer – Medknow Publications 2024-12-01
Series:Biomolecular and Health Science Journal
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Online Access:https://journals.lww.com/10.4103/bhsj.bhsj_17_24
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Summary:The array of potential differential diagnoses of cutaneous lupus erythematosus (CLE) is extensive. Exclusion of infection is paramount, given the patient’s immunodeficient state. We report the case of a 33-year-old female patient who presented with pruritic erythematous papules across her upper extremities, originally presumed to be a drug eruption. Cutaneous xerosis and desquamation involving the hands were also noted, concomitant with diffuse hair loss and onychodystrophy. Potassium hydroxide and culture analysis from nail scrapings aligned with onychomycosis. Concurrently, histopathological assessment of the skin biopsy illustrated subacute CLE. Following the completion of the antifungal, mycophenolate mofetil was initiated, owing to suboptimal outcomes observed with the previous treatment modalities. The resolution of scaling on the scalp was concomitant with the emergence of new hair growth. Alopecia in lupus erythematosus patients mandates a thorough examination, owing to the extensive spectrum of its potential causes. Involvement of the nails mandates a rigorous exclusion of infections.
ISSN:2620-8636