A New Vision about Folliculitis Decalvans and Lichen Planopilaris: Two Distinct Entities or a Continuous Phenotypic Spectrum?
Abstract
Folliculitis decalvans and lichen planopilaris have been considered two distinct cicatricial alopecias. However, biphasic presentation of folliculitis decalvans - lichen planopilaris in the same patient has been recently described, therefore raising the doubt if they are two distinct entities or a continuous phenotypic spectrum.
We describe the case of a man who presented clinical, trichoscopic, and histopathological features of both entities. Moreover, we discuss current theories about the pathogenesis of the two diseases and their coexistence in the same patient. The recognition of similar cases allows to optimize the approach and treatment.
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References
Olsen EA, Bergfeld WF, Cotsarelis G, et al. Summary of North American Hair Research Society (NAHRS)-sponsored Workshop on Cicatricial Alopecia, Duke University Medical Center, February 10 and 11, 2001. J Am Acad Dermatol. 2003;48: 103-110.
Yip L, Barrett TH, Harries MJ. Folliculitis decalvans and lichen planopilaris phenotypic spectrum: a case series of biphasic clinical presentation and theories on pathogenesis. Clin Exp Dermatol. 2020;45(1):63-72. DOI: 10.1111/ced.13989.
Egger A, Stojadinovic O, Miteva M. Folliculitis Decalvans and Lichen Planopilaris Phenotypic Spectrum-A Series of 7 New Cases With Focus on Histopathology. Am J Dermatopathol. 2020;42(3):173-177. DOI: 10.1097/DAD.0000000000001595.
Bolduc C, Sperling LC, Shapiro J. Primary cicatricial alopecia: Lymphocytic primary cicatricial alopecias, including chronic cutaneous lupus erythematosus, lichen planopilaris, frontal fibrosing alopecia, and Graham-Little syndrome. J Am Acad Dermatol. 2016;75(6):1081-1099. DOI: 10.1016/j.jaad.2014.09.058.
Bolduc C, Sperling LC, Shapiro J. Primary cicatricial alopecia: Other lymphocytic primary cicatricial alopecias and neutrophilic and mixed primary cicatricial alopecias. J Am Acad Dermatol. 2016;75(6):1101-1117. DOI: 10.1016/j.jaad.2015.01.056.
Bernárdez C, Molina-Ruiz AM, Requena L. Histologic features of alopecias: part II: scarring alopecias. Actas Dermosifiliogr. 2015;106(4):260-70. DOI: 10.1016/j.ad.2014.06.016.
Morais KL, Martins CF, Anzai A, Valente NYS, Romiti R. Lichen Planopilaris with Pustules: A Diagnostic Challenge. Skin Appendage Disord. 2018 Apr;4(2):61-66. DOI: 10.1159/000478268.
Otberg N, Kang H, Alzolibani AA, Shapiro J. Folliculitis decalvans. Dermatol Ther. 2008;21(4):238-44. DOI: 10.1111/j.1529-8019.2008.00204.x.
Kang H, Alzolibani AA, Otberg N, Shapiro J. Lichen planopilaris. Dermatol Ther. 2008;21(4):249-56. doi: 10.1111/j.1529-8019.2008.00206.x.
Harries MJ, Meyer K, Chaudhry I, E Kloepper J, Poblet E, Griffiths CE, et al. Lichen planopilaris is characterized by immune privilege collapse of the hair follicle's epithelial stem cell niche. J Pathol. 2013;231(2):236-47. DOI: 10.1002/path.4233.
Ramot Y, Bertolini M, Boboljova M, Uchida Y, Paus R. PPAR-γ signalling as a key mediator of human hair follicle physiology and pathology. Exp Dermatol. 2020;29(3):312-321. DOI: 10.1111/exd.14062.
Moreno-Arrones OM, Campo RD, Saceda-Corralo D, Jimenez-Cauhe J, Ponce-Alonso M, Serrano-Villar S, et al. Folliculitis decalvans microbiological signature is specific for disease clinical phenotype. J Am Acad Dermatol. 2020;S0190-9622(20)32894-2. DOI: 10.1016/j.jaad.2020.10.073.
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