Lichen Planopilaris
Lichen planopilaris (LPP) is an uncommon inflammatory condition that affects the hair follicles, primarily on the scalp, leading to scarring hair loss (cicatricial alopecia). It is characterised by redness, scaling, and follicular hyperkeratosis (raised bumps). The exact cause of LPP is unknown, but it is thought to be an autoimmune condition and is a variant of lichen planus that specifically targets hair follicles.
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Key Points
- Lichen planopilaris (LPP) is a rare inflammatory hair disorder leading to scarring alopecia (permanent baldness).
- Presents as redness, scaling, and hair loss, mainly on the scalp.
- Aetiology is unknown, but it's considered a variant of lichen planus affecting hair follicles.
- Early diagnosis and treatment can help manage symptoms and prevent further hair loss.
- Mainly affects middle-aged women but can occur in anyone.
What is lichen planopilaris?
Lichen planopilaris is a condition where an inflammatory process destroys hair follicles, resulting in permanent hair loss. It is one of the primary forms of scarring alopecia and is often accompanied by symptoms like itching and discomfort on the scalp.
- Destroys hair follicles, causing permanent hair loss.
- A primary form of scarring alopecia.
- Often accompanied by itching and discomfort.
Who gets lichen planopilaris?
Lichen planopilaris primarily affects middle-aged women, although it can occur in men and women of all ages. The exact reasons why certain individuals develop LPP are not fully understood, but it may involve genetic and environmental factors. Contact Melbourne skin clinic for dermatology services and treatments tailored to your skin care needs.
- Primarily affects middle-aged women.
- Can occur in both genders at any age.
- Exact causes are unknown.
Clinical features
LPP typically presents with redness, scaling, and follicular hyperkeratosis around hair follicles on the scalp. It can lead to patches of scarring hair loss where the skin may appear smooth and shiny. Sometimes, symptoms can include burning, tenderness, or pain in the affected areas.
- Presents with redness, scaling, and follicular hyperkeratosis.
- Leads to scarred patchy hair loss.
- Symptoms may include burning, tenderness, or pain.
Diagnosis and differential diagnosis
Diagnosis of LPP is often made through a combination of clinical examination, dermoscopy, and scalp biopsy. Differential diagnosis includes other forms of scarring alopecia such as discoid lupus erythematosus and folliculitis decalvans.
- Diagnosed via clinical examination, dermoscopy, and biopsy.
- Differentiated from other forms of scarring alopecia.
Impact and complications
Lichen planopilaris can lead to permanent hair loss and significant psychological distress. It is a progressive condition. Early diagnosis and treatment is important to prevent extensive hair loss and minimise emotional impact.
- Leads to permanent hair loss and psychological distress.
- Progressive condition; early treatment is crucial.
Treatment options for lichen planopilaris
The treatment for lichen planopilaris focuses on reducing inflammation and preventing further hair loss. Topical treatments, including cortisone lotions, retinoids and calcineurin inhibitors, are commonly used to alleviate symptoms. Oral treatments such as hydroxychloroquine, tetracyclines, or other immunosuppressants may be prescribed. Intralesional corticosteroids can be directly injected into the affected areas to reduce inflammation more effectively. It’s also advised to practice gentle hair care and avoid traumatic styling techniques to minimise further damage. While treatment can help manage symptoms and slow the progression of the condition, it’s important to understand that hair regrowth in areas that have already scarred is unlikely.
- Treatment focuses on reducing inflammation and preventing hair loss.
- Includes topical and oral medications, and intralesional corticosteroids.
- Gentle hair care is recommended.
- Treatment can manage symptoms but unlikely to regrow hair in scarred areas.
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