Senior Member mr_peanutbutter Posted May 26 Senior Member Share Posted May 26 Sadly i cannot find many pictures on the matter but is there a visual thumbrule how to distinguish between normal male pattern baldness and Lichen Planopilaris in the Androgenetic Alopecia Area? Something you can detect with your eyes without using a biopsy? „Background Classic lichen planopilaris (LPP) is a patchy form of primary lymphocytic cicatricial alopecia localized on the vertex of the scalp. It is important, however, to be aware of other, less recognized presentations that may be missed without dermatoscopy and pathology. Methods and Results We report 26 patients with LPP presenting with subtle erythema and scaling colocalized in the area of patterned thinning (androgenetic alopecia, AGA). All patients had been treated for seborrheic dermatitis in the past. Dermatoscopy showed the presence of 2-4 hairs emerging as a tuft from the same ostium surrounded by erythema, peripilar casts and interfollicular scaling associated with hair miniaturization. Histopathology obtained from those areas corresponded to LPP with concomitant follicular miniaturization. Conclusion Subtle or focal cases of LPP may be missed for seborrheic dermatitis when overlapping with AGA. Dermatoscopy-guided biopsy from the affected scalp is the best approach to make a timely diagnosis. This is particularly important in patients with AGA evaluated to undergo hair transplantation, as active LPP is a contraindication for these patients.“ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4857822/ „Background: Lichen planopilaris (LPP) is a scarring alopecia rarely described in men. Objective: To investigate the clinical and histopathologic features of LPP in men. Methods: We performed a retrospective cohort study of male patients with LPP seen at Mayo Clinic between 1992 and 2016. Results: Nineteen men with biopsy-confirmed LPP were included. The disease most commonly presented with diffuse (42.1%) or vertex scalp (42.1%) involvement. None of the patients had eyebrow or body hair involvement. Perifollicular erythema (94.7%) and pruritus (57.9%) were the most frequent clinical findings. Androgenetic alopecia (AGA) co-occurred in 26.3% of patients. Mucosal lichen planus was found in four patients (21.1%). Thyroid disease occurred in three patients (15.8%). Disease improvement (47.3%) occurred with combination topical and systemic therapy, topical clobetasol monotherapy, and minocycline monotherapy. Conclusions: LPP in men has similar clinical and histologic presentations as reported in women. Nonscalp hair loss appears less likely in men with classic LPP than reported in men with frontal fibrosing alopecia, while mucosal lichen planus and thyroid disease appear to be more common in classic LPP. Men with AGA can present with new-onset concomitant LPP. Limitations included small study size, variable follow-up, and lack of standardized clinical assessment due the study's retrospective nature.“ https://pubmed.ncbi.nlm.nih.gov/33128471/ „Of the 182 men studied, 7 men, with a median age of 53 when they were diagnosed, were diagnosed with FFA. Following biopsies, they were all also found to have lichen planopilaris. FFA causes a different type of receding hairline to that commonly seen in patients with Male Pattern Hair Loss. Instead of gradually thinning or causing a widow's peak, FFA leads to a wide band of smooth bald skin around the entire frontal hairline. " https://www.belgraviacentre.com/blog/study-finds-frontal-fibrosing-alopecia-hair-loss-also-occurs-in-mendas 1 Link to comment Share on other sites More sharing options...
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