Diagnosis: Lichen planopilaris
Description: Patchy scarring hair loss
Morphology: Hair loss diffuse
Site: Scalp
Sex: F
Age: 39
Type: Clinical
Submitted By: Ian McColl
Differential DiagnosisHistory:
Lichen planopilaris or follicular lichen planus may involve only the scalp or other hair bearing areas.It is a scarring process in which the hair follicles are destroyed and an area of permanent baldness ensues.Hair follicles adjacent to the bald areas may show perifollicular redness and scaling in the follicle opening.The bald scalp areas are smoothe with the loss of follicular openings.
The second case shown here shows the variant of lichen planopilaris known as frontal fibrosing alopecia where there is progressive destruction of the hair follicles with a slowly receding hairline.