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

This case report details a 33-year-old woman with a complex form of cicatricial alopecia, exhibiting features of both folliculitis decalvans and lichen planopilaris, termed the FDLPPs spectrum. Initially misdiagnosed, her condition was correctly identified after multiple biopsies. Treatment with baricitinib and adalimumab stabilized her alopecia and reduced inflammation. The report highlights the diagnostic challenges of FDLPPs and the potential of targeted immunomodulatory therapies, emphasizing the need for repeated evaluations and personalized treatment strategies. Understanding specific inflammatory and fibrotic patterns is crucial for effective management of these scalp disorders.