The simultaneous occurrence of lichen planopilaris and alopecia areata: A report of two cases and literature review

Abstract

Although the coexistence of alopecia areata and lichen planopilaris is rare, if alopecic patches appear abruptly, this possible association should be kept in mind.

Keywords: alopecia; alopecia areata; lichen planopilaris.

Figure 1

Clinical and histopathological findings. A, Diffuse hair loss of the scalp and partial hair loss with perifollicular erythema and scaling of the eyebrow. B, Perifollicular erythema and scaling in some residual terminal hair of occipital area. C, Gray‐brown macules and patches on the chin and top of the lip. D, Complete loss of follicles. A fibrous streamer extends along the site of the previous follicle (HE, ×100). E, F, The lichenoid infiltrate confined to perifollicular location (HE, ×100). The insert shows basal cell vacuolization and civatte bodies (HE, ×400). G, There is vacuolar degeneration of basal layer with subtle lymphocytic infiltration and marked melanin incontinence (HE, ×400)

Figure 2

Clinical and histopathological findings. (A) A well‐defined patch of nonscarring alopecia at the temporal region of scalp. B, Irregular patch of scarring alopecia with perifollicular erythema and a patch of nonscarring alopecia in beard area. C, Diffuse scaring alopecia on the top of the head and vertex. D, E Vertical section showing a decreased number of terminal anagen hairs and increased number of telogen and vellus‐like follicles. A few peribulbar lymphocytic infiltration around miniaturized hairs is seen (HE, ×40). The insert shows more details (HE, ×100). F, G, There is lichenoid infiltration around upper port of terminal follicles with fibromucinous change around another one (HE, ×40; HE, ×100, respectively). H, I, A subtle lichenoid infiltration and prominent fibromucinous change are around upper port of a terminal anagen follicle. The epidermis is normal (HE, ×40). The insert shows lichenoid infiltration involving the basal layer of the follicular epithelium (HE, ×400)

Figure 3

A, Temporal region, before treatment. C, E, Beard region before treatment. B, Temporal region, after a 3‐mo treatment. D, F, Beard region, after a 6‐mo treatment