Dermnet Videos
Alopecia Videos
- Alopecia areata – Causes and Associated Conditions
- Alopecia Areata Information
- Alopecia Areata Treatment
- Course of Sudden Hair Loss Telogen Effluvium
- Evaluation and Treatment of Sudden Hairloss Telogen Effluvium
- Female Pattern Baldness and Hair Loss Causes
- Female Pattern Baldness and Hair Loss in Women
- Female Pattern Hair Loss Evaluation and Testing
- Female Pattern Hair Loss Treatment
- Hair loss and Alopecia Introduction
- Hair Loss Due To Hair Pulling – Trichotillomania
- Hair Loss Treatment and Male Pattern Baldness Medicine
- Loose Anagen Hair Syndrome
- Male Patern Baldness Causes and Hair Loss
- Male Pattern Baldness and Hair Loss Information
- Sudden Hair Loss Telogen Effluvium
- Traction Alopecia Hair Loss
- Traction Alopecia Hair Loss Treatment
- Central Centrifugal Cicatricial Alopecia
- Discoid Lupus Erythematosus – Clinical
- Discoid Lupus Erythematosus – Histology
- Discoid Lupus Erythematosus – Treatment
- Follicular Degeneration Syndrome
- Folliculitis Decalvans – Clinical
- Folliculitis Decalvans Treatment
- Hair Loss Alopecia With Scarring Information
- Lichen Planopilaris
- Lichen Planopilaris – Clinical Features
- Lichen Planopilaris Treatment
Video Topics
Discoid Lupus Erythematosus – Treatment
Intralesional triamcinolone, at doses of 5 to 10 mg/cc, are often effective at treating existing scalp lesions (lower concentrations should be used for facial lesions). I recommend against initial concomitant use of superpotent topical steroids and intralesional triamcinolone, as this combination can result in significant atrophy. If the patient is not developing new lesions, topical and intralesional steroids can be the mainstays of treatment. However, these treatment modalities do not prevent development of new plaques; this requires systemic therapy.
Hydroxychloroquine, or Plaquenil, is the most effective systemic therapy with the least amount of toxicity for DLE patients. After obtaining a baseline complete blood count (CBC), liver function tests (LFTs), a G6-P-D, and an eye exam by an ophthalmologist, start hydroxychloroquine at a dose of 400 mg a day. Repeat the CBC and LFTs about one month after initiating therapy, and then every 4 to 6 months. An eye exam should be performed by an ophthalmologist every 6 to 12 months while on hydroxychloroquine to screen for early retinopathy. Once the patient has responded, the hydroxychloroquine dose can be dropped to 200 mg/day and maintained for months to a few years to prevent recurrence of the disease. If hydroxychloroquine is not effective after 2 months of therapy, quinacrine (Atabrine) can be added. This medication is only available in the United States through compounding pharmacies.
Other systemic medications which have proven beneficial for patients with DLE include thalidomide, dapsone, isotretinoin, and methotrexate.