From Misdiagnosis to Targeted Therapy: A Case Report of Folliculitis Decalvans and Lichen Planopilaris Phenotypic Spectrum

    November 2025
    Armin Gorjian, Mehdi Ghahartars, Fatemeh Sari Aslani
    TLDR Accurate diagnosis is crucial for effective treatment of similar hair loss conditions.
    This case report discusses the phenotypic spectrum of Folliculitis Decalvans (FD) and Lichen Planopilaris (LPP), two forms of cicatricial alopecia. FD is characterized by a neutrophilic immune reaction to microbial biofilms, leading to perifollicular pustules, crusting, and tufted follicular papules. The report highlights the challenges in diagnosing these conditions due to their overlapping clinical features and emphasizes the importance of accurate diagnosis for effective targeted therapy. The case underscores the need for awareness of the phenotypic spectrum to avoid misdiagnosis and ensure appropriate treatment strategies are employed.
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