ABSTRACT
Introducción: La alopecia fibrosante frontal, considerada por algunos autores como un subtipo de liquen plano pilaris, corresponde a una alopecia cicatricial primaria, que se presenta en mujeres adultas y se caracteriza por el retroceso simétrico de la línea de implantación fronto temporal. Se presenta un estudio descriptivo de pacientes con Alopecía fibrosante frontal atendidos en este centro. Objetivos: Evaluar características clínicas, dermatoscópicas e histopatológicas de pacientes con alopecia fibrosante frontal. Materiales y métodos: Estudio retrospectivo de pacientes con diagnóstico clínico-histopatológico de alopecia fibrosante frontal atendidos en nuestro centro desde Julio 2010 a Octubre 2012. Resultados: Se encontraron 57 casos con diagnóstico histológico de alopecia cicatricial, de los cuales 8 (14 por ciento) se diagnosticaron como Alopecia Fibrosante Frontal. El 100 por ciento correspondieron a mujeres, el promedio de edad fue de 45 años. Sólo la mitad de los casos comenzó con la alopecia luego del climaterio. El hallazgo clínico más frecuentemente encontrado fue el retroceso de la línea de implantación frontotemporal (87,5 por ciento); y en segundo lugar la disminución difusa de densidad capilar (37,5 por ciento) y alopecia de la cola de las cejas (50 por ciento). No se reportó ningún caso asociado a liquen plano cutáneo o de mucosas. Los hallazgos más relevantes a la dermatoscopía fueron: eritema perifolicular (50 por ciento) e hiperqueratosis folicular (25 por ciento). A la histopatología, los principales hallazgos fueron el infiltrado inflamatorio linfocitario perifolicular (50 por ciento) y fibrosis concéntrica perifolicular (100 por ciento). Discusión: La Alopecia fibrosante frontalrepresenta el 14 por ciento de las alopecias cicatriciales primarias en nuestra serie. La edad al diagnóstico fue inferior a lo reportado en la literatura. El principal hallazgo clínico fue el retroceso de la línea de implantación frontotemporal...
Introduction: Frontal fibrosing alopecia, considered by some authors as a subtype of lichen planopilaris, is a scarring alopecia that usually involves adult women and is characterized by the symmetric recession of fronto-temporal hairline. Objectives: Characterize the clinical, dermoscopic and histological features of frontal fibrosing alopecia. Materials and Methods: We conducted a retrospective study of patients with clinical and histological diagnosis of Frontal Fibrosing Alopecia treated in our institution from July 2010 to October2012. Results: 8 out of 57 cases with histological diagnosis of scarring alopecia, had diagnosis of frontal fibrosing alopecia (14 percent). 100 percent were women, with mean age of 45 years. 50 percent of patients began with alopecia in the post-climacteric period. Recession of frontotemporal hair-line was the most common finding (87.5 percent), associated with reduced capillary density (37.5 percent) and loss of eyebrows (50 percent). In our study, none of the patients had other signs of lichen planus. At dermoscopy, most common finding were perifollicular erythema (50 percent) and follicular hyperkeratosis (25 percent). Most common histological findings were a perifollicular lymphocytic inflammatory infiltrate (50 percent) and perifollicular concentric fibrosis (100 percent). Discussion: Frontal fibrosing alopecia represents 14 percent of scarring alopecia in our series. Age at diagnosis was lower than reported in the literature, and only 50 percent of women presented alopecia in the postmenopausal period. The main clinical finding was the recession of frontotemporal hairline...
Subject(s)
Humans , Male , Adult , Female , Middle Aged , Alopecia/diagnosis , Alopecia/epidemiology , Alopecia/pathology , Biopsy , Dermoscopy , Diagnosis, Differential , Lichen Planus/diagnosis , Retrospective StudiesABSTRACT
El liquen plano pilaris lineal de la cara (LPPL) es una rara variante de liquen plano pilaris, caracterizado por presentar pápulas foliculares asintomáticas en una configuración lineal. Hay pocos casos reportados en hombres adultos y menos aún en mujeres. El liquen plano pigmentoso (LPP) es también una forma diferente del liquen plano clásico, con un curso clínico prolongado, se manifiesta con máculas marrones oscuras. Describimos un caso muy raro de liquen plano pilaris pigmentado con una distribución lineal en áreas del mentón y cuello en una paciente mujer.
Linear lichen planopilaris (LPPL) of the face is a rare variant of lichen planus pilaris, characterized by asymptomatic follicular papules in a linear configuration. There are few reported cases in adult men and even less in woman. Lichen planus pigmentosum is also a different presentation of classic lichen planus with a prolonged clinical course and dark brown macules. We describe a very rare case of LPPL pigmentosus with a linear distribution on the neck and chin in a female patient.
Subject(s)
Humans , Female , Adult , Facial Dermatoses , Lichen PlanusABSTRACT
Lichen planopilaris is a follicular variant of lichen planus. When it appears on the scalp and is accompanied with hair loss, it is classified into a subtype of cicatrical alopecia. And lichen planopilaris can be classified into classic lichen planopilaris, frontal fibrosing alopecia, Graham-Little syndrome. A 63-year-old man presented with a 3-year history of hair loss on the area of occipital skin and 3-week history of pruritic, confluent, purple-colored, flat-topped papules on the same area with decreased follicular ostium. Histopathological findings showed both characteristics of the cicatricial alopecia and those of lichen planus; Loss of the hair follicles, atrophy of the sebaceous gland and sweat gland, and bandlike inflammatory infiltration on the upper dermis, especially on the perifollicular and interfollicular area.
Subject(s)
Humans , Middle Aged , Alopecia , Atrophy , Dermis , Hair , Hair Follicle , Lichen Planus , Lichens , Scalp , Sebaceous Glands , Skin , Sweat GlandsABSTRACT
Lichen planopilaris is believed to be a variant of lichen planus which is occasionally accompanied by classical lichen planus. A 68-year old male had asymptomatic skin colored or light violet colored papules and nodules on the occipital area followed by hair loss for 2 months. He had also violaceous pea to bean sized whitish scaly papules on the right lower extremity. Histopathological examination revealed the dilated follicles to be filled with horny material. There were also intense infiltrations of monocytes which were most prominent at the lower pole of the hair follicles on the scalp lesion. There was also hyperkeratosis, focal hypergranulosis and band-like infiltrations of lymphocytes at the dermo-epidermal junction on the lesion of the lower extremity. Direct immunofluorescence examination showed linear deposition of fibrin at the dermo-epidermal junction in the hair follicles. We had an opportunity to observe a man with lichen planopilaris who had loss of scalp hair which was accompanied by classical lichen planus on the lower extremity.
Subject(s)
Aged , Humans , Male , Fibrin , Fluorescent Antibody Technique, Direct , Hair , Hair Follicle , Lichen Planus , Lichens , Lower Extremity , Lymphocytes , Monocytes , Pisum sativum , Scalp , Skin , ViolaABSTRACT
A 26-year-old Korean woman had a 5 month history of pruritic, keratotic papules on the scalp, trunk, and pubic area, which were accompanied by diffuse hair loss from the scalp, eyebrows and pubic area. She also had flat-topped violaceous papules on the scalp and pubic area, and white lace-like striae on the oral mucous and hard palate. Histopathologic study of the progressive stages of the disease revealed dilated follicles filled with horny material, hyperkeratosis, hypergranulosis and hydropic degeneration of the basal cell layer. Throughout the entire subepidermal region, there was an intense bandlike infiltration of mononuclear cells, which were most prominent at the lower pole of the hair follicles. The late stage of the disorder showed atrophy of the epidermis and atrophy of the hair follicles with fibrotic tracts, and mild mononuclear infiltrate at the sites of the former hair follicles. This is the first recorded case, to the best of cur knowledge, in Korea.