Lichen Planopilaris in the Androgenetic Alopecia Area: A Pitfall for Hair Transplantation

January 2015 in “ Skin appendage disorders ”

Katherine L. Baquerizo Nole, Bernard P. Nusbaum, Giselle Martins Pinto, Mariya Miteva

lichen planopilaris androgenetic alopecia hair transplantation scalp biopsy scalp disorders hair thinning red scaly scalp LPP AGA

TLDR Misdiagnosis of LPP in AGA patients can cause hair transplant issues.

This article discusses the potential for misdiagnosis of lichen planopilaris (LPP) in patients with androgenetic alopecia (AGA) who are seeking hair transplantation. The authors note that subtle LPP can be difficult to distinguish from AGA, and that scalp biopsies are crucial for accurate diagnosis. They also provide a table summarizing the differential diagnosis of scalp disorders characterized by hair thinning and a red, scaly scalp. The authors emphasize the importance of proper diagnosis in patients who do not respond to standard treatment and in those seeking hair transplantation.

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Research cited in this study

9 / 9 results

research The Annual Changes of Clinical Manifestation of Androgenetic Alopecia Clinic in Korean Males and Females: An Outpatient-Based Study

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AGA increased yearly, type I most common, and family history and seborrheic dermatitis often linked.

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Hair transplants can lead to hair loss from lichen planopilaris, and patients should be tested and wait two years before the procedure.

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Fibrosing alopecia in a pattern distribution is a unique hair loss condition that may respond to antiandrogen therapy.

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Trichoscopy can diagnose female hair loss with high accuracy by looking for specific patterns in hair and scalp appearance.

The Ludwig Pattern of Androgenetic Alopecia Is Due to a Hierarchy of Androgen Sensitivity Within Follicular Units That Leads to Selective Miniaturization and a Reduction in the Number of Terminal Hairs Per Follicular Unit

research The Ludwig Pattern of Androgenetic Alopecia Is Due to a Hierarchy of Androgen Sensitivity Within Follicular Units That Leads to Selective Miniaturization and a Reduction in the Number of Terminal Hairs Per Follicular Unit

47 citations, September 2008 in “British Journal of Dermatology”

Ludwig pattern hair loss in women results from varying sensitivity in hair follicles, causing fewer visible hairs.

research A Case-Series of 29 Patients with Lichen Planopilaris: The Cleveland Clinic Foundation Experience on Evaluation, Diagnosis, and Treatment

113 citations, May 2007 in “Journal of the American Academy of Dermatology”

The study found that steroids and tetracycline helped treat active Lichen planopilaris, and hair transplants were good for later stages.

research Fibrosing Alopecia in a Pattern Distribution

158 citations, February 2000 in “Archives of dermatology”

Some people with pattern hair loss may also have scalp inflammation and scarring similar to lichen planopilaris.

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Scalp biopsies are crucial for diagnosing hair loss conditions like Diffuse Unpatterned Alopecia (DUPA) and retrograde hair loss, as treatments like finasteride and dutasteride may not be effective if other conditions are present. Combining PPAR-GAMMA agonists with retinoids could improve treatments for conditions like Lichen Planopilaris.

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DUPA and retrograde alopecia may not be solely DHT-based, and a biopsy is crucial for accurate diagnosis and treatment. Treatments mentioned include dutasteride, oral minoxidil, pioglitazone, clobetasol, calcipotriol, ketoconazole, and doxycycline, depending on the specific condition.

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Men with hair loss might have lichen planopilaris (LPP), which can mimic androgenetic alopecia, leading to misdiagnosis and ineffective treatment with finasteride or dutasteride. Proper diagnosis, including biopsies, is crucial to distinguish between androgenetic alopecia and conditions like LPP.

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Lichen Planopilaris (LPP), a form of permanent hair loss, which can be mistaken for seborrheic dermatitis and is characterized by scalp itching, burning, redness, and dandruff. Treatment options discussed include steroidal creams, finasteride, minoxidil, and RU58841.

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