Lichen Planopilaris Arising between Two Linear Surgical Scars

Area of Science:

• Dermatology
• Pathology

Background:

• Lichen planopilaris (LPP) is a lymphocytic cicatricial alopecia.
• LPP can present atypically and be misdiagnosed early on.
• Early diagnosis of LPP is challenging before significant hair loss occurs.

Observation:

• A rare case of LPP developed between surgical scars years post-operation.
• Dermoscopy and biopsy confirmed the LPP diagnosis.
• Lesion localization suggested a link to oxidative stress from impaired lymph flow.

Findings:

• Oxidative stress due to lymphatic flow issues may trigger LPP.
• Oral roxithromycin, an antibiotic with anti-oxidative and anti-inflammatory effects, was administered.
• Roxithromycin effectively halted the progression of LPP in this case.

Implications:

• This case highlights LPP's potential to manifest in unusual post-surgical scalp sites.
• The findings suggest a novel mechanism involving oxidative stress and lymph flow in LPP pathogenesis.
• Roxithromycin shows promise as a treatment to stop LPP progression, warranting further investigation.