LPP and AGA have MANY shared options!
There are numerous options of lichen planopilaris and androgenetic alopecia which can be the identical. Each circumstances have perifollicular fibrosis though the diploma of fibrosis could typically be extra in LPP (however not at all times). Each circumstances have irritation. Not stunning … it’s simple to get confused.
Lichen planopilaris is a harmful course of and ideally I prefer to have AT LEAST ONE PIECE OF GOOD EVIDENCE pointing to destruction, particularly:
1) loss, discount or no less than atrophy of sebaceous glands or
2) demise of hair follicle keratinocytes (lichenoid change or necrosis).
If I don’t have any of those two, I’d just like the pathologist to assist me determine 3) if elastic tissue has been destroyed utilizing some sort of elastin stain.
If none of those three options are current and clinically the story doesn’t match with scarring alopecia, we both have to abandon the unique analysis or rebiopsy once more to attempt to show this can be a scarring alopecia!!!!
I encourage medical doctors I work with to get within the behavior of crossing out the phrases “perifollicular fibrosis” and “perifollicular irritation “ in biopsy reviews and seeing what info is left over. If the report appears unusual or incomplete … one must name the pathologist for extra info or rebiopsy!
