A person with an inflammatory autoimmune disease is probably aware of the condition and is under treatment. And while scalp involvement is not likely to be the way the disease presents. However, involvement of the scalp may occur over the course of the disease and ahs the potential to become a significant problem for the patient. Lichen planus and lupus erythematosus are two such diseases that may involve the scalp. Alopecia areata is a disease of presumably autoimmune origin that causes hair loss.
The disease lichen planus draws its name from the appearance of characteristic lesions-lichen-like, furrowed scales and papules on skin, mucous membranes, fingernails and toenails, and across hair follicles on the scalp. Like the mossy-appearing plants that grow flat along the surfaces of rocks.
The cause of lichen planus is unknown, but genetic factors and dysfunction of the immune system appear to be involved. Some investigators suggest that a predisposition to the disease may be triggered by infection or exposure to an environmental agent. Once triggered, an immune system dysfunction may cause the immune system to launch an attack on the body's own cells. A failure of self-recognition by the immune response is called autoimmunity.
The form of lichen planus involving hair follicles is called follicular lichen planus or planopilaris. Damage to hair follicles can cause scalp scarring and permanent hair loss. End-stage lichen planus of the scalp is characterized by complete hair loss and extensive scalp scarring.
Lupus erythematosus is also a disease of unknown, but probably autoimmune origin. Systemic lupus erythematosus (SLE) involves multiple organs and is progressively disabling. Discoid lupus erythematosus (DLE) is a form that involves only the skin; characteristic features are patchy skin inflammation, scaling of the skin, plugging of hair follicles, telangiectasia (rupture of small blood vessels just under the surface of the skin) and excessive skin dryness. DLE can result in scalp scarring and permanent hair loss. Neither form of lupus erythematous can be treated with over the counter treatments; all lupus patients should be under the care of a dermatologist or other physician with knowledge and experience of lupus symptoms and treatment.
Alopecia Areata is the most common cause of hair loss other than androgenetic alopecia (male- and female-pattern hair loss). Its cause is unknown, but autoimmunity has been suggested on the basis of research. Find more discussion of alopecia areata at (see Genes, Hair Growth and Hair Loss).