Lichen Planopilaris (LPP): Many different presentations

Many Different Presentations

Lichen planopilaris (LPP) is one of the more commonly encountered of the approximately one dozen different so called “primary scarring alopecias.” Lichen planopilaris can present very differently in different patients. Some patients have tremendous itching, or burning or scalp tenderness and other patients have none. Some have intense redness in the scalp (like the patient here in this photo) and others have only subtle pinkness. Some have scaling around hairs (such as in the photo here), and others have little to none. Despite these differences, all patients with LPP share in common an inflammatory process directed towards select hair follicles that has the potential to lead to its destruction. Responses to treatment also differs with some responding very well to even limited therapies and others responding poorly to even aggressive systemic immunosuppressive treatments.