66-Year-Old Female with Itchy Scalp and Hair Loss

    January 2022 in “ Clinical Cases in Dermatology ”
    Mara Ernst, Jennifer Viola, Suchita Sampath, Shannon C. Trotter
    TLDR A woman has a permanent hair loss condition treated with steroids and new medicines, but hair might not regrow.
    Lichen planopilaris (LPP) is a type of cicatricial alopecia leading to permanent hair loss, predominantly affecting Caucasian and Indian women. It has several subtypes, including classic, frontal fibrosing, and Graham-Little-Piccardi-Lasseur, each targeting different scalp areas. The pathogenesis involves upregulation of cell-mediated immunity and JAK expression, causing follicular destruction. Treatments aim to halt scarring, with first-line options being topical and intralesional corticosteroids. Novel treatments like pioglitazone and tofacitinib show promise based on case studies. Patients should be informed that regrowth of destroyed follicles may not be possible, and mental health impacts should be considered in treatment planning.
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