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Lichen planopilaris.

V N Sehgal1, P Bajaj

  • 1Dermato-Venereology (Skin/VD) Centre, Sehgal Nursing Home, A-6 Panchwati, Azadpur, Delhi-110 033, India. drsehgal@ndf.vsnl.net.in

International Journal of Dermatology
|November 13, 2001
PubMed
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This study details a rare case of lichen planopilaris presenting with slate-blue eruptions and scarring alopecia. Histopathological analysis revealed distinct epidermal and follicular changes, aiding in diagnosis.

Area of Science:

  • Dermatology and Pathology
  • Cutaneous immunology
  • Hair follicle biology

Background:

  • Lichen planopilaris (LPP) is an inflammatory condition causing scarring alopecia.
  • It often presents with perifollicular erythema and scaling, leading to irreversible hair loss.
  • Co-occurrence with classic lichen planus (LP) is uncommon but documented.

Observation:

  • A 20-year-old male presented with a decade-long history of progressive hair loss, pruritus, and slate-blue follicular papules.
  • Clinical examination revealed scarring alopecia on the scalp and classic lichen planus lesions on non-hairy skin.
  • Histopathology confirmed epidermal changes of LP and distinct follicular alterations in LPP, including keratin plugs and dermal inflammation.

Findings:

  • Microscopic examination of scalp lesions showed epidermal atrophy, basal cell vacuolization, and perifollicular infiltrate characteristic of LPP.

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  • Abdominal skin lesions exhibited hyperkeratosis, granular layer thickening, and basal cell degeneration consistent with LP.
  • Key findings included obliterated pilo-sebaceous orifices, dermal fibrosis, and pigment-laden macrophages in LPP lesions.

    • Implications:

    • This case highlights the varied clinical presentation of lichen planopilaris, emphasizing the importance of histopathological correlation.
    • Understanding the distinct histopathological features of LPP and LP is crucial for accurate diagnosis and management.
    • Further research into the immunopathogenesis of LPP may reveal novel therapeutic targets for hair loss disorders.