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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

Fibrosing alopecia in a pattern distribution and cicatricial pattern hair loss are poorly recognized diffuse variants of lichen planopilaris (LPP).


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.


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


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.


Low number of cases due to rarity of the diseases.


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.

© 2019  American Academy of Dermatology, Inc.@@#104156@@
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