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Microglia are activated by the increased production of pro-inflammatory and anti-inflammatory cytokines, chemokines, and other inflammatory molecules, and increased glutamate release, all of which remain in microglia (Hoeijmakers et al., 2016)

Inflammation may itself cause demyelination, as in MS, in which leptomeningeal immune cell infiltration and compartmentalized inflammation within the subarachnoid space are tightly associated with the development of cortical lesions (Choi et al., 2018)

ALDH2, aldehyde dehydrogenase 2

Of note, our patient did have a background of previous scattered atrophic cicatricial alopecic plaques involving the scalp in areas of discoid lupus involvement (Figure 2)

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