Diffuse variants of scalp Lichen Planopilaris: clinical, trichoscopic and histopathologic features of 40 patients

BACKGROUND: Fibrosing Alopecia in a Pattern Distribution (FAPD) and Cicatricial Pattern Hair Loss (CPHL) are poorly recognized diffuse variants of Lichen Planopilaris (LPP).

OBJECTIVES: The medical features of 40 patients affected by a diffuse hair thinning associated with a long-lasting history of pruritus and erythema of the scalp and a histopathological diagnosis of LPP were reviewed.

METHODS: Clinical, trichoscopy, histopathology, response to treatment and follow-up were analyzed.

RESULTS: Eighteen patients were diagnosed with FAPD and two patients with CPHL. Furthermore, a new variant of diffuse LPP named "Lichen Plano-Pilaris Diffuse Pattern" was described in 20 subjects.

LIMITATIONS: Low number of cases due to rarity of the disease.

CONCLUSIONS: In patients complaining of a long-lasting history of scalp erythema, itching/dysesthesia and diffuse hair thinning it's advisable to consider diffuse variants of LPP.