Lichen planopilaris (LPP)

Lichen Planopilaris

LPP is a type of scarring alopecia where hair loss is permanent. This makes it all the more important to secure the correct diagnosis with minimal delay.

Sometimes that is easier said than done. This picture shows an image of a female patient's scalp. At first look one could easily conclude this female patient has genetic hair loss. However, looking closer it reveals subtle scale around hair follicles (called perifollicular scale, PFS. Most of the hairs that are remaining (and shown in the photo) are the same diameter. There is not much in the way of miniaturization that is expected in pure androgenetic alopecia.

Treatments for LPP include: topical steroids, steroid injections, calcineurin inhibitors, oral pills including prednisone, hydroxychloroquine, doxycycline, methotrexate and others.