Diffuse variants of scalp lichen planopilaris: Clinical, trichoscopic, and histopathologic features of 40 patients.

Background:Fibrosing alopecia in a pattern distribution and cicatricial pattern hair loss are poorlyrecognized diffuse variants of lichen planopilaris (LPP).Objectives:The medical features of 40 patients affected by a diffuse hair thinning associated with a long-lastinghistory of pruritus and erythema of the scalp and ahistopathologic diagnosis of LPP were reviewed.Methods:Clinical data, results of trichoscopy and histopathology, response to treatment, and follow-upwere analyzed.Results:There were 18 patients diagnosed with fibrosing alopecia in pattern distribution and 2 patientswith cicatricial pattern hair loss. A new variant of diffuse LPP, named ‘‘lichen planopilaris diffuse pattern,’’was described in 20 individuals.Limitations:Low number of cases due to rarity of the diseases.Conclusion:In patients complaining of a long-lasting history of scalp erythema, itching/dysesthesia,and diffuse hair thinning, it is advisable to consider diffuse variants of LPP.