Finally, the patient sees some improvement
We discussed the risks and benefits of the various treatments, and our patient elected to start hydroxychloroquine (Plaquenil), 200 to 400 mg/day orally (not to exceed 6.5 mg/kg per day). We referred her for a baseline ophthalmological exam and stressed that she needed a repeat exam every 6 to 12 months while she remained on the hydroxychloroquine. We also referred her to a rheumatologist.
After 4 months of treatment, she showed some improvement (FIGURE 2), with no side effects from the medication. The patient was subsequently lost to follow-up.
FIGURE 2
A visible improvement
After 4 months of treatment with hydroxychloroquine, the patient’s scalp lesions improved and there was evidence of hair growth.
CORRESPONDENCE: Ahunna Ahiarah, MD, UB Family Medicine, 1315 Jefferson Avenue, Buffalo, NY 14208; aahiarah@buffalo.edu