Katherine L Baquerizo Nole1, Bernard Nusbaum2, Giselle M Pinto3, Mariya Miteva1. 1. Department of Dermatology, Miller School of Medicine, University of Miami, Miami, Fla., USA. 2. Hair Transplant Institute of Miami, Coral Gables, Fla., USA. 3. Department of Dermatology, Santa Casa Hospital and Ambulatory of Sanitary Dermatology, Porto Alegre, Brazil.
Abstract
BACKGROUND: Classic lichen planopilaris (LPP) is a patchy form of primary lymphocytic cicatricial alopecia localized on the vertex of the scalp. It is important, however, to be aware of other, less recognized presentations that may be missed without dermatoscopy and pathology. METHODS AND RESULTS: We report 26 patients with LPP presenting with subtle erythema and scaling colocalized in the area of patterned thinning (androgenetic alopecia, AGA). All patients had been treated for seborrheic dermatitis in the past. Dermatoscopy showed the presence of 2-4 hairs emerging as a tuft from the same ostium surrounded by erythema, peripilar casts and interfollicular scaling associated with hair miniaturization. Histopathology obtained from those areas corresponded to LPP with concomitant follicular miniaturization. CONCLUSION: Subtle or focal cases of LPP may be missed for seborrheic dermatitis when overlapping with AGA. Dermatoscopy-guided biopsy from the affected scalp is the best approach to make a timely diagnosis. This is particularly important in patients with AGA evaluated to undergo hair transplantation, as active LPP is a contraindication for these patients.
BACKGROUND: Classic lichen planopilaris (LPP) is a patchy form of primary lymphocytic cicatricial alopecia localized on the vertex of the scalp. It is important, however, to be aware of other, less recognized presentations that may be missed without dermatoscopy and pathology. METHODS AND RESULTS: We report 26 patients with LPP presenting with subtle erythema and scaling colocalized in the area of patterned thinning (androgenetic alopecia, AGA). All patients had been treated for seborrheic dermatitis in the past. Dermatoscopy showed the presence of 2-4 hairs emerging as a tuft from the same ostium surrounded by erythema, peripilar casts and interfollicular scaling associated with hair miniaturization. Histopathology obtained from those areas corresponded to LPP with concomitant follicular miniaturization. CONCLUSION: Subtle or focal cases of LPP may be missed for seborrheic dermatitis when overlapping with AGA. Dermatoscopy-guided biopsy from the affected scalp is the best approach to make a timely diagnosis. This is particularly important in patients with AGA evaluated to undergo hair transplantation, as active LPP is a contraindication for these patients.
Authors: Roberto d'Ovidio; Concetta Sgarra; Anna Conserva; Umberto Filippo Angelotti; Roberta Erriquez; Caterina Foti Journal: Head Face Med Date: 2007-02-08 Impact factor: 2.151
Authors: Daniela Pinto; Francesco Maria Calabrese; Maria De Angelis; Giuseppe Celano; Giammaria Giuliani; Fabio Rinaldi Journal: PLoS One Date: 2022-07-18 Impact factor: 3.752