A Case of Scarring Alopecia

    December 2005 in “ Journal of the American Academy of Physician Assistants ”
    Sven M. Hochheimer, Kimberly L. Maino
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    TLDR The woman was diagnosed with lichen planopilaris and can be treated with corticosteroids.
    A white woman presented with a pruritic, balding, tender area on her posterior scalp that had not improved with ketoconazole 2% shampoo. Physical examination revealed scarring alopecia with perifollicular erythema and scaling. Negative KOH test and fungal culture results, along with two punch biopsies, led to a diagnosis of lichen planopilaris (LPP). LPP is an idiopathic condition that can be treated with topical corticosteroids, and in more severe cases, intralesional corticosteroids or immune modulators. Differential diagnoses included discoid lupus erythematosus, tinea capitis, and alopecia areata, but these were excluded based on clinical and histopathological findings.
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