DLE is an autoimmune condition and is the most common form of chronic cutaneous lupus erythematosus. Clinically, the lesions start as discoid erythematous patches which then develop into plaques with follicular plugging and scaling. Eyelid findings include blepharitis, lid scarring, entropion, and ectropion. Scaly plaques on the eyelids with loss of hair follicles results in madarosis [Figure 3]. Numerous studies have reported the mimicking of a chronic blepharitis by DLE.[35,61–63] A high index of suspicion is necessary in such cases, where the diagnosis is very often delayed by months to years. Biopsy with histopathological examination should be done to confirm the diagnosis. Treatment with hydroxychloroquine results in a regrowth of the eyelashes.
While these factors contribute to hair loss for any woman, it’s particularly dicey for those of us with PCOS because when the follicle is exposed to our elevated androgens such as DHT (di-hydro testosterone, an active metabolite of testosterone) it gets damaged. Whenever a cell is damaged it generates oxidative stress which further alters the androgen receptor in the follicle perpetuating the issue.