Lichen Planus – Lichen Planopilaris

Planopilaris is the specific name given to lichen planus of the scalp. This worldwide disease presents as follicular and perifollicular violaceous scaly, often intensely pruritic papules which usually result in small circumscribed areas of scarring alopecia.

The disease is usually seen in adults (more frequently females).  The onset usually occurs between the ages of 25 and 70 years, typically in the mid-40s to early 50s. Children are less commonly affected.  All races are susceptible. Familial cases have been recorded.

The advancement may be slow or aggressive. It can affect all age groups but is more common in 4th – 6th decade women.

This disease is thought to be responsible for a high percentage of cases of cicatricial (scarring) alopecia.

Pseudopelade may be the diagnosis given. Differential diagnosis with Chronic Lupus Erythematosus (discoid) may prove difficult.

It has been suggested that some clinical/pathological features of lichen planus can be drug induced in predisposed individuals.

Treatment: Oral / topical steroids may be helpful.

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