Is Keratosis Pilaris associated with Lichen Planopilaris?

Is keratosis pilaris associated with lichen planopilaris?

 
I’ve selected this question below for this week’s question of the week. It allows us to review the link (or lack of a link) between lichen planopilaris and keratosis pilaris

Question

I would like to know if there is a link between keratosis pilaris and lichen planopilaris (LPP). I have both and wondered if it’s coincidental or a true link?

Answer

Thanks for the question! The answer is - maybe and maybe not!

40 % of adults in the general population have keratosis pilaris. That means 40 % of your neighbors have keratosis pilaris and 40 % of your friends do too.

But 40 % of adults don’t have lichen planopilaris. In fact, about 1:1500 to 1:2500 adults have lichen planopilaris.

That means that there are lots and lots of people with keratosis pilaris who don’t have LPP and never will develop this condition.

In fact, about 99.93 % of people with keratosis pilaris will never develop lichen planopilaris.

So what is the relationship of keratosis pilaris and LPP then?

Well, a very very small proportion of patients with keratosis pilaris have a more extensive form of the condition which is associated with keratosis pilaris like papules affecting the abdomen, and other parts of the body sometimes too along with a clinically non-scarring hair loss condition affecting the pubic area and underarms (called the axillae) and sometimes the eyebrows too. This is called the Graham Little-Piccardi-Lassueur syndrome.

Summary

In summary, keratosis pilaris is sometimes linked to LPP but usually not. Almost half of the world has keratosis pilaris and not surprisingly a great proportion of patients with LPP have keratosis pilaris too. However, the more and more that the patient’s keratosis pilaris affects the abdominal skin and eyebrows as opposed to just the back of the arms, the more likely it is that there is a link between the two conditions. The same is true for those with loss of hair in the underarm and pubic region. 

Keratosis pilaris plus lichen planopilaris does not automatically equal Graham Little-Piccardi-Lassueur syndrome. However, keratosis pilaris associated with hair loss in the underarm area and pubic area, eyebrows and keratosis pilaris type papules on the abdomen together with LPP does.