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follicular lichen planus; lichen planopilaris; Graham Little-Piccardi-Lassueur syndrome

follicular form of lichen planus Etiology: - autoimmune Epidemiology: - rare - women affected > men - typical age of onset 40-60 years Pathology: - lymphocyte mediated lichenoid perifollicular inflammation Clinical manifestations: - perifollicular violaceous erythema & keratotic plugs - lichen planus on the skin, nails, &/or mucosa may be present - keratotic lichenoid follicular papules & plaques resulting in scarring alopecia - non-scarring loss of pubic hair & axillary hair * images [5] Complications: - major psychological consequences - relapses are common after local or systemic treatment Management: - topical glucocorticoids, intralesional glucocorticoids, oral glucocorticoids [3] - hydroxychloroquine [3] - immunosuppressants [3]

Specific

frontal fibrosing alopecia

General

lichen planus

References

  1. Color Atlas and Synopsis of Clinical Dermatology, Common and Serious Diseases, 3rd ed, Fitzpatrick et al, McGraw Hill, NY, 1997, pg 267
  2. Assouly P, Reygagne P. Lichen planopilaris: update on diagnosis and treatment. Semin Cutan Med Surg. 2009 Mar;28(1):3-10 PMID: 19341936
  3. Medical Knowledge Self Assessment Program (MKSAP) 17, American College of Physicians, Philadelphia 2015
  4. Racz E, Gho C, Moorman PW, Noordhoek Hegt V, Neumann HA. Treatment of frontal fibrosing alopecia and lichen planopilaris: a systematic review. J Eur Acad Dermatol Venereol. 2013 Dec;27(12):1461-70 PMID: 23531029
  5. DermNet NZ. Lichen planopilaris (images) http://www.dermnetnz.org/hair-nails-sweat/lichen-planopilaris.html