Hair loss and “dirty ears” – Musings of a NYC dermatologist

The woman pictured above came in complaining of hair loss in a spot over a six-month period.  A biopsy confirmed a diagnosis of discoid lupus erythematous–an autoimmune disease.  The diagnosis could have been made six years earlier, however, if the patient had realized that her hair dye was not the cause of the discoloration in her ears.  She claimed she never seemed to be able to get the dye out of her ears.  Do you think your ears are dirty and you cannot seem to get them clean no matter how hard you scrub them?  It probably isn’t hair dye or dirt.   It may be lupus.  Get evaluated by a dermatologist.

Lupus erythematosus is a chronic autoimmune disease that can affect any organ in the body–including the skin.  Discoid lupus is a cutaneous form of lupus that usually affects the head and neck but may also be more generalized.  People with discoid lupus should be evaluated for involvement of other organs, however, it is uncommonly associated disease other than on the skin.  Women are twice as likely to be affected as men.  Sun avoidance is an important part of management.   Discoid lupus can cause scarring, discoloration and permanent hair loss.  Biopsy of a small area of skin can confirm the diagnosis.


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