Diffuse variants of scalp lichen planopilaris: Clinical, trichoscopic, and histopathologic features of 40 patients

Background

Fibrosing alopecia in a pattern distribution and cicatricial pattern hair loss are poorly recognized diffuse variants of lichen planopilaris (LPP).

Objectives

The medical features of 40 patients affected by a diffuse hair thinning associated with a long-lasting history of pruritus and erythema of the scalp and a histopathologic diagnosis of LPP were reviewed.

Methods

Clinical data, results of trichoscopy and histopathology, response to treatment, and follow-up were analyzed.

Results

There were 18 patients diagnosed with fibrosing alopecia in pattern distribution and 2 patients with cicatricial pattern hair loss. A new variant of diffuse LPP, named "lichen planopilaris diffuse pattern," was described in 20 individuals.

Limitations

Low number of cases due to rarity of the diseases.

Conclusion

In patients complaining of a long-lasting history of scalp erythema, itching/dysesthesia, and diffuse hair thinning, it is advisable to consider diffuse variants of LPP.