Lichen Planopilaris With Foreign-Body Granuloma

The document presented a case of a 60-year-old man with Lichen Planopilaris (LPP) accompanied by foreign-body granuloma, a condition more common in LPP/frontal fibrosing alopecia (FFA) than in alopecia areata (AA). The patient had a history of perifollicular pigmentation and reduced hair density for 2.5 years. A biopsy showed periinfundibular fibrosing dermatitis with foreign-body giant cells around hair shaft material, without signs of infection. The authors proposed that the presence of granulomas with fibrosis in a superficial periinfundibular location could be a diagnostic marker for late-stage LPP/FFA. They highlighted the need for careful clinicopathological evaluation in diagnosing alopecia, especially when granulomas complicate the histological picture.