Lichen Planopilaris with Koebner Phenomenon

September 2018 in “ JAAD Case Reports ”

Leena Alahmari, Rawan K. AlMesned, Ahmed Alhumidi, Abdullah Alkhalifah

lichen planopilaris Koebner phenomenon traction temporal scalp scarring alopecia perifollicular erythema scaling topical corticosteroids intralesional corticosteroids oral corticosteroids central centrifugal cicatricial alopecia LPP CCCA

TLDR Lichen planopilaris can be triggered by prolonged scalp traction and can be treated with corticosteroids.

This case report described a 25-year-old woman with lichen planopilaris (LPP) triggered by prolonged traction on her temporal scalp, a unique and previously unreported cause. The patient presented with bilateral focal temporal hair loss, pain, redness, itching, and burning sensations. Examination revealed scarring alopecia with perifollicular erythema and scaling. Treatment included topical, intralesional, and oral corticosteroids, leading to complete remission after cessation of the traction practice. This case highlighted the importance of recognizing unusual triggers for LPP and differentiating it from similar conditions like central centrifugal cicatricial alopecia (CCCA). Further studies were recommended to understand LPP's precipitating factors and pathologic mechanisms.

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