Lichen Planopilaris Caused by Wig Attachment: A Case of Koebner Phenomenon in Frontal Fibrosing Alopecia

January 2018 in “ International Journal of Trichology ”

Priscila Taguti, Hudson Dutra, Ralph M. Trüeb

Frontal Fibrosing Alopecia Lichen Planopilaris scarring alopecia Koebner phenomenon isomorphic reaction scalp trauma inflammation FFA LPP

TLDR Wearing a wig caused a skin condition to develop in a woman with hair loss.

In 2018, a case study of a 59-year-old woman with Frontal Fibrosing Alopecia (FFA) showed that she developed Lichen Planopilaris (LPP), a type of scarring alopecia, at the sites of her wig attachments. This was the first reported case of FFA where LPP developed due to pressure from wig attachments, demonstrating the Koebner phenomenon, which is the development of skin lesions at the site of physical trauma. The study suggested that wigs could potentially trigger an isomorphic reaction in patients with FFA and concluded that patients with FFA should be cautious about scalp trauma and consider treatments that minimize irritation and inflammation.

View this study on journals.lww.com →

Discuss this study in the Community →

Cited in this study

6 / 6 results

research Graft Versus Host Disease Presenting as Fibrosing Alopecia in a Pattern Distribution: A Model for Pathophysiological Understanding of Cicatricial Pattern Hair Loss

9 citations , January 2018 in “International Journal of Trichology”

A woman's hair loss from graft versus host disease helps understand similar hair loss conditions.

research Clinical Description of Frontal Fibrosing Alopecia with Concomitant Lichen Planopilaris

13 citations , September 2017 in “Skin appendage disorders”

Some women with Frontal Fibrosing Alopecia also have Lichen Planopilaris, which can lead to more symptoms and affect hair outside the scalp.

research Cutaneous Lupus Erythematosus Presenting as Frontal Fibrosing Alopecia: Report of 2 Patients

12 citations , January 2017 in “Skin appendage disorders”

Two patients with skin lupus were mistakenly thought to have a different scalp condition but improved with lupus treatment.

research Follicular Lichen Planus Caused by Wig Use: An Unusual Case of Koebner Phenomenon

1 citations , June 2016 in “Actas Dermo-Sifiliográficas”

Wearing a wig caused a woman's skin condition to worsen due to pressure from the wig's fasteners.

research Nail Involvement in Frontal Fibrosing Alopecia

17 citations , January 2015 in “International Journal of Trichology”

Frontal fibrosing alopecia may affect nails and could be a type of lichen planus, treatable with certain medications.

research Postmenopausal Frontal Fibrosing Alopecia: A Frontal Variant of Lichen Planopilaris

329 citations , January 1997 in “Journal of the American Academy of Dermatology”

Frontal fibrosing alopecia is a hair loss condition in postmenopausal women, similar to lichen planopilaris, with ineffective treatments.

6 / 6 results

research Treatment of Frontal Fibrosing Alopecia and Lichen Planopilaris

July 2023 in “IntechOpen eBooks”

The best treatment for Frontal Fibrosing Alopecia and Lichen Planopilaris combines oral and topical medications to reduce symptoms and stop hair loss.

research Hair and Nail Conditions: Alopecia Evaluation

1 citations , June 2022 in “PubMed”

Alopecia causes hair loss and should be treated early, especially scarring types where hair cannot regrow.

research A Rare Case of Keratosis Follicularis Spinulosa Decalvans Affecting a Female Child

January 2022 in “Clinical dermatology review”

A girl with a rare skin condition called Keratosis Follicularis Spinulosa Decalvans showed no significant improvement with treatment.

research Isotretinoin for the Treatment of Facial Lichen Planopilaris: A New Indication for an Old Drug, a Case Series Study

6 citations , August 2020 in “Clinical case reports”

Isotretinoin was not effective in treating facial lichen planopilaris.

research Incidental Syringomas of the Scalp in a Patient with Scarring Alopecia

4 citations , July 2015 in “Case Reports in Dermatology”

A woman with unexplained hair loss was found to have harmless skin tumors and a scarring hair loss condition, but the tumors didn't cause the hair loss.

research Clinical Features of Primary Cicatricial Alopecia in Chinese Patients

28 citations , January 2014 in “Indian Journal of Dermatology, Venereology and Leprology”

Chinese patients with primary cicatricial alopecia often have folliculitis decalvans, benefit from treatment, but may experience relapse, with dermoscopy being a useful diagnostic tool.