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Journal of the American Academy of Dermatology
Sous presse. Epreuves corrigées par l'auteur. Disponible en ligne depuis le vendredi 7 février 2020
Doi : 10.1016/j.jaad.2019.11.006
accepted : 3 November 2019
Diffuse variants of scalp lichen planopilaris: Clinical, trichoscopic, and histopathologic features of 40 patients
 

Michela Starace, MD a, Gloria Orlando, MD b, , Aurora Alessandrini, MD a, Carlotta Baraldi, MD a, Francesca Bruni, MD a, Bianca Maria Piraccini, MD, PhD a
a Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy 
b Unit of Dermatology, Department of Medicine-DIMED, University of Padova, Padova, Italy 

Correspondence to: Gloria Orlando, MD, Unit of Dermatology, Department of Medicine-DIMED, University of Padova, Via Gallucci 4, 35121 Padova, Italy.Unit of DermatologyDepartment of Medicine-DIMEDUniversity of PadovaVia Gallucci 4Padova35121Italy
Abstract
Background

Fibrosing alopecia in a pattern distribution and cicatricial pattern hair loss 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 histopathologic diagnosis of LPP were reviewed.

Methods

Clinical data, results of trichoscopy and histopathology, response to treatment, and follow-up were analyzed.

Results

There were 18 patients diagnosed with fibrosing alopecia in pattern distribution and 2 patients with cicatricial pattern hair loss. A new variant of diffuse LPP, named “lichen planopilaris diffuse pattern,” was described in 20 individuals.

Limitations

Low number of cases due to rarity of the diseases.

Conclusion

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

The full text of this article is available in PDF format.

Key words : cicatricial alopecia, fibrosing alopecia, fibrosing alopecia in pattern distribution, histopathology, lichen planopilaris, scalp itching, trichoscopy

Abbreviations used : CPHL, FAPD, LPP, LPPD



 Funding sources: None.
 Conflicts of interest: None disclosed.
 IRB approval status: This study did not require Institutional Review Board approval.
 Reprints not available from the authors.



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