Department of Dermatology (Drs. Privalle and Wetter), Department of Family Medicine (Dr. MacLaughlin), and Division of Rheumatology (Dr. Thanarajasingam), Mayo Clinic, Rochester, MN ashleyprivalle@gmail.com
DEPARTMENT EDITOR Richard P. Usatine, MD University of Texas Health, San Antonio
The authors reported no potential conflict of interest relevant to this article.
This patient’s nonadherence to treatment and lack of precautionary steps exacerbated this condition.
A 23-year-old woman with systemic lupus erythematosus (SLE) and a history of poor adherence to recommended treatment presented with a widespread pruritic rash and diffuse hair loss. The rash had rapidly progressed following sun exposure during the summer. The patient cited her mental health status (anxiety, depression), socioeconomic factors, and challenges with prescription insurance coverage as reasons for nonadherence to treatment.
Clinical examination revealed diffuse scarring alopecia and abnormal pigmentation of the scalp (FIGURE 1A), as well as large, red-brown, scaly, atrophic plaques on the face, ears, extremities, back, and buttocks (FIGURES 1B and 1C).
WHAT IS YOUR DIAGNOSIS? HOW WOULD YOU TREAT THIS PATIENT?
