A histologic review of 27 patients with lichen planopilaris.

A histologic review of 27 patients with lichen planopilaris.

Tandon Yasmeen K; Somani Najwa; Cevasco Nathaniel C; Bergfeld Wilma F

Journal of the American Academy of Dermatology

2008

2008-07

BACKGROUND: Lichen planopilaris (LPP) is a potential trichologic emergency that can result in permanent scarring alopecia. Histopathology is a key component of the diagnostic work-up. OBJECTIVE: To identify the key histologic features that characterize LPP in order to facilitate diagnosis, ultimately leading to improved patient outcomes. METHODS: Scalp biopsy specimens from 27 confirmed cases of LPP were reviewed in a blinded fashion to determine diagnostically helpful histologic features. RESULTS: Absence of arrector pili muscles and sebaceous glands, a perivascular and perifollicular lymphocytic infiltrate in the reticular dermis and mucinous perifollicular fibroplasia within the upper dermis with absence of interfollicular mucin, and superficial perifollicular wedge-shaped scarring were characterizing features. LIMITATIONS: Sample size was limited, given that biopsy specimens were taken from lesions at varying stages of evolution and findings vary with disease stage. CONCLUSIONS: This study confirms many previously reported histologic features and highlights new characterizing features of mucinous perifollicular fibroplasia.

Adult; Aged; Alopecia/etiology/*pathology; Biopsy; Cicatrix/etiology/*pathology; Female; Humans; Lichen Planus/complications/diagnosis/*pathology; Male; Middle Aged; Retrospective Studies; Scalp Dermatoses/diagnosis/*pathology; Scalp/*pathology

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