Clinicopathologic Lessons in Distinguishing Cicatricial Alopecia: 7 Cases of Lichen Planopilaris Misdiagnosed as Discoid Lupus

    September 2014 in “ Journal of The American Academy of Dermatology ”
    Vinod E. Nambudiri, Ruth Ann Vleugels, Alvaro C. Laga, Lynne J. Goldberg
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    TLDR Seven patients were misdiagnosed with discoid lupus instead of lichen planopilaris due to similar symptoms, showing the need for careful diagnosis in scarring hair loss conditions.
    The document reports on a study of seven patients who were initially diagnosed with discoid lupus erythematosus but were later correctly diagnosed with lichen planopilaris after further evaluation at specialty clinics in Boston. The study underscores the diagnostic challenges in differentiating between types of lymphocytic scarring alopecia due to similar clinical and histologic features. Key factors in correctly diagnosing lichen planopilaris included the presence of perifollicular erythema and scale without follicular plugging or central depigmentation, and histopathological evidence of perifollicular inflammation. The study stresses the necessity of clinicopathologic correlation for accurate diagnosis and highlights common pitfalls that can lead to misdiagnosis.
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