Videodermoscopy of Active Lichen planopilaris (LPP)

Videodermoscopy of active lichen planopilaris (LPP). Lichen planopilaris is an immune based scarring hair loss condition that has the potential to lead to permanent destruction of hair follicles. In this video, intense redness can be seen in the scalp. Density of hairs is less than normal due to the progressive destruction. The architecture is altered and many hairs appear as single hairs rather than the bundles of 1.2 and 3 hairs. The scale around some of the hairs is very typical of LPP. The patient is itchy, has burning and is shedding more than normal. Treatment options are many but include topical steroids, steroid injections, topical calcineurin inhibitors, doxycycline, hydroxychloroquine, methotrexate, isotretinoin, mycophenolate, cyclosporine, tofacitinib (topical or oral).