Diffuse Lichen Planopilaris Masquerading as Diffuse Alopecia Areata

The document discusses a case of a 32-year-old woman who was initially diagnosed with diffuse alopecia areata, but was later found to have diffuse lichen planopilaris (LPP) and female pattern hair loss. LPP, a form of follicular lichen planus, primarily affects women aged 30 to 60. Due to the complexity and atypical nature of the patient's condition, dermoscopy-guided vertical and horizontal biopsies were used to improve diagnostic accuracy. The patient was treated with oral corticosteroids, minoxidil, and spironolactone. The study highlights the need for immediate treatment to stop disease progression and long-term follow-up, as the disappearance of clinical signs does not necessarily mean the disease has stopped progressing.