Lichen Planopilaris describes a rare cutaneous version of Lichen Planus in which the hair follicles show changes. The disease can occur alone or in combination with other forms of lichen planus.
Lichen Planopilaris usually manifests between the ages of 40 and 60 and affects more women than male patients. Typical symptoms include perifollicular inflammation and hair loss.
These symptoms are most common on the scalp, but all hair-bearing areas of the body may be affected. The edges of the affected areas show perifollicular erythema, scales partially keratotic cones. Also areas of scarring alopecia with missing follicle openings are characteristic signs.
Frontal fibrosing alopecia (FFA) and Lassueur-Graham-Litte syndrome are two variants of lichen Planopilaris. Signs of FFA are the loss of eyebrows and progressive, symmetrical hair loss of the hair's front hairline. In Lassueur-Graham-Litte syndrome, there is a combination of non-scarring alopecia of the axillary and pubic hairs with lichen planus follicularis of the scalp with follicular keratosis.
The cause of the disease is unknown. It is believed that LPP is an autoimmune disease that causes T lymphocytes to attack unknown antigens of the keratocytes and destroy the cells. Possible triggers are pharmacological substances, infectious agents and contact allergens.