Co-Localization of Alopecia Areata and Lichen Planopilaris in a Patient Receiving Immunosuppressants: A Rare Case

A 37-year-old woman with a history of hypothyroidism and lupus erythematosus arthritis, who was on long-term immunosuppressive treatment, developed both alopecia areata (AA) and lichen planopilaris (LPP). Despite her immunosuppressive regimen, she experienced general scalp alopecia, particularly on the vertex, with mild itching and trichodynia. Treatment with Minoxidil 5%, Clobetasol solution, and an increased dose of Azathioprine led to the resolution of follicular hyperkeratosis and scalp erythema, and hair regrowth was observed in AA spots after 3 months. This case highlighted the potential mutual immunopathogenesis of AA and LPP and the possibility of new autoimmune diseases emerging even under immunosuppressive therapy.