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. 2008 Jul;59(1):91-8.
doi: 10.1016/j.jaad.2008.03.007.

A histologic review of 27 patients with lichen planopilaris

Yasmeen K Tandon  1 , Najwa Somani, Nathaniel C Cevasco, Wilma F Bergfeld
Affiliations

A histologic review of 27 patients with lichen planopilaris

Yasmeen K Tandon et al. J Am Acad Dermatol. 2008 Jul.

Abstract

Background: Lichen planopilaris (LPP) is a potential trichologic emergency that can result in permanent scarring alopecia. Histopathology is a key component of the diagnostic work-up.

Objective: To identify the key histologic features that characterize LPP in order to facilitate diagnosis, ultimately leading to improved patient outcomes.

Methods: Scalp biopsy specimens from 27 confirmed cases of LPP were reviewed in a blinded fashion to determine diagnostically helpful histologic features.

Results: Absence of arrector pili muscles and sebaceous glands, a perivascular and perifollicular lymphocytic infiltrate in the reticular dermis and mucinous perifollicular fibroplasia within the upper dermis with absence of interfollicular mucin, and superficial perifollicular wedge-shaped scarring were characterizing features.

Limitations: Sample size was limited, given that biopsy specimens were taken from lesions at varying stages of evolution and findings vary with disease stage.

Conclusions: This study confirms many previously reported histologic features and highlights new characterizing features of mucinous perifollicular fibroplasia.

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