Clinical Presentation

■ Several clinical presentations of lichen planopilaris (LPP).

■ Some patients present with small areas of scarring alopecia that often involve the vertex. There are minute red follicular papules with fine scaling at the base of the terminal hairs at the periphery of the areas of scarring (Fig. 13A). These papules indicate active inflammation that will eventually lead to scarring and loss of the affected follicles.

■ Extremely early LPP presents as plaques of these minute red scaling follicular papules without associated hair loss.

■ Other patients with LPP have a large area of central scarring alopecia on the crown, the so-called central centrifugal cicatricial alopecia (CCCA) or central centrifugal scarring alopecia (CCSA). The area of hair loss slowly expands centrifugally. The active edges of the lesion again demonstrate minute red follicular scaling papules.

■ Patients with LPP often complain of pain, stinging, or burning in the areas of active disease.

■ A rare presentation of LPP is fulminant disease that can result in complete alopecia in months to a year's time (Fig. 13B). These patients have very inflamed red scaling plaques, which on biopsy show changes of LPP.

■ Some patients with LPP have concomitant cutaneous, oral, and/or genital lichen planus.

■ Most patients with LPP do not have lichen planus elsewhere on the body.

■ Frontal fibrosing alopecia (FFA) is felt to be a distinctive clinical variant of LPP. Patients with FFA are usually

Clinical Feature

Histopathologic Feature

Traction traumatizes

Increased numbers of

follicles

telogen/catagen follicles

Long-standing disease is

Markedly decreased follicular

permanent

density with loss of terminal

How To Deal With Rosacea and Eczema

How To Deal With Rosacea and Eczema

Rosacea and Eczema are two skin conditions that are fairly commonly found throughout the world. Each of them is characterized by different features, and can be both discomfiting as well as result in undesirable appearance features. In a nutshell, theyre problems that many would want to deal with.

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