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Image Number 177 (Lichen planopilaris)

Hair loss diffuse

Diagnosis: Lichen planopilaris

Site: Scalp

Sex: F

Age: 39

Type: Clinical

Description: Patchy scarring hair loss

Submitted by: Ian McColl

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Differential Diagnosis


Lichen planopilaris or follicular lichen planus may involve only the scalp or other hair bearing areas.It is a scarring process in which the hair follicles are destroyed and an area of permanent baldness ensues.Hair follicles adjacent to the bald areas may show perifollicular redness and scaling in the follicle opening.The bald scalp areas are smoothe with the loss of follicular openings.

The second case shown here shows the variant of lichen planopilaris known as frontal fibrosing alopecia where there is progressive destruction of the hair follicles with a slowly receding hairline.

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