Frontal Fibrosing Alopecia and Lichen Planus Pigmentosus: Diagnosis and Therapeutic Challenge

Frontal fibrosing alopecia (FFA) is a type of lichen planopilaris characterized by progressive hair loss on the scalp, eyebrows, and axillae. This report described a postmenopausal woman with FFA and lichen planus pigmentosus (LPP), which began with eyebrow alopecia and progressed to the frontoparietal region, accompanied by difficult-to-manage periocular and cervical hyperpigmentation. The condition was managed with systemic corticosteroids and finasteride. LPP, an uncommon variant of lichen planus, is often associated with FFA in individuals with darker skin types and presents with scarring alopecia and skin hyperpigmentation that is resistant to various treatments. This case highlighted the diagnostic and therapeutic challenges of managing scarring alopecia and perifollicular hyperpigmentation.