ABSTRACT
The clinical course of lichen planopilaris (LPP) may be insidious or fulminant, and the pattern of scalp hair loss is highly variable. Most commonly, there are several scattered foci of partial hair loss (Figures 19.1 and 19.2). Perifollicular erythema and scaling are almost always present (Figure 19.3). A pattern of hair loss suggestive of central, centrifugal scarring alopecia (Figure 19.4) or pseudopelade of Brocq can also occur. As in all cases of inflammatory scarring alopecia, LPP can heal with the formation of polytrichia (tufting; Figure 19.5). Clearly, there can be some clinical overlap with other forms of scarring alopecia. Therefore, the diagnosis of LLP cannot be based on clinical features alone.
