Lichen planopilaris is the specific name given to lichen planus in hair bearing region of skin (usually the scalp) that may cause permanent, scarring alopecia

In fact, up to 40% of scarring alopecia cases that an expert will see are due to lichen planopilaris. Lichen planopilaris is seen in individuals as young as 13 years old. The hair loss caused by lichen planopilaris presents itself as distinct patches of hair loss that may expand and coalesce over time. The condition develops so slowly that even after several years of the disease the patches of alopecia may be small and inconspicuous. Lichen planopilaris is a poorly understood form of hair loss and there is much confusion in distinguishing it from systemic lupus erythematosus, frontal fibrosing alopecia, and another disease called mixed inflammatory destructive alopecia. Some experts claim that lichen planopilaris is the same as pseudopelade, however, the majority of experts believe there are subtle distinctions between the two diseases. Skin biopsies are often employed when diagnosing lichen planopilaris. Within the skin there may be an abnormal infiltration of primary lymphocyte immune cells and deposition of immunoglobulins. Some experts may use direct immunofluorescence staining techniques to look for antibody deposits in the affected tissue. Other experts have found that staining biopsy tissues with dyes specific for elastic fibres significantly help to diagnose lichen planopilaris from other scarring alopecias. Simple biopsy staining procedures can also help in indentifying lichen planopilaris. Sometimes there is inflammation around the affected hair follicles, especially in the early stages of disease development, however, inflammation is not always present. Despite the presence of an immune response, not all experts regard lichen planopilaris as an immune medicated disease. The most popular treatment methods involve use of corticosteriods. However, the effectiveness of these treatments varies considerably from person to person. A recent thread in our forum was started by a member with Lichen planopilaris. Click here to view the thread

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