Although lichen planopilaris is rare, it is one of the common causes of scarring hair loss of the. In dle, inflammation is not restricted to surrounding hairs, and the affected skin can become telangiectatic. Typical papules of lichen planus are not observed on the scalp. Lichen pilaris a skin disease manifested by the eruption of dense acuminate papules with a convoluted downy hair growing spirally through the center of each. Differentiation of pityriasis rubra pilaris from plaque psoriasis by dermoscopy. Since there is no possibility of regrowth in the scarred areas, the goal of treatment is to prevent enlargement of the.
In 1883, crocker published a description of lichen spinulosus. Of all the alopecias, both nonscarring and scarring, lichen planopilaris is the most difficult to treat. Successful treatment of lichen spinulosus with topical adapalene. Individual lesion shows conical projection, hair like horny. Lichen planopilaris treatment dermatology education. Lichen planopilaris, also called follicular lichen or follicular lichen planus. Lichen planus et acuminatus atrophicans jama network.
For language access assistance, contact the ncats public information officer. Get a printable copy pdf file of the complete article 593k, or click on a page image below to browse page by page. Full text full text is available as a scanned copy of the original print version. Diagnosis and treatment of lichen planus richard p. Evidence for neurogenic inflammation in lichen planopilaris and. The etiology is unknown but genetic predisposition has been suggested as a possible cause. Lichen planopilaris, a subtype of lichen planus, is an inflammatory condition characterized by patchy or diffuse hair loss with erythematous papules and keratotic follicular lesions that evolve to cicatricial alopecia. This page may contain terms or definitions that are offensive or inappropriate for some readers. The topic lichen pilaris you are seeking is a synonym, or alternative name, or is closely related to the medical condition keratosis pilaris quick summary. Lichen planus lp is a chronic inflammatory and immune mediated disease that affects the skin, nails, hair, and mucous membranes. Lpp is considered a follicular form of lichen planus based upon shared pathologic features and the frequent coexistence of clinical findings of these disorders. Lichen spinulosus is a clinically distinctive variant of keratosis pilaris. Genetic and rare diseases information center gard po box 8126, gaithersburg, md 208988126 tollfree. The lesions may arise from normal skin or they may occur as a complication of other forms of dermatitis.
Therapeutic management of classic lichen planopilaris. Lichen spinulosus is an uncommon dermatosis manifested by large patches of follicular papules topped by keratotic spines, as shown in the image below. Fortunately, most cases of lichen planus of the mouth cause minimal problems. It has a tendency to disappear spontaneously at puberty.
Lichen planopilaris pictures, causes, treatment, diagnosis. Lichen spinulosus is a rare skin disorder characterized by follicular keratotic papules that are grouped into large patches. Mechanical trauma, such as scratching or rubbing the area, is a factor in its development. Pityriasis rubra pilaris is a benign, chronic skin disorder in which the skin becomes red, swollen, rough, and dry.
The topic lichen ruber pilaris you are seeking is a synonym, or alternative name, or is closely related to the medical condition pityriasis rubra pilaris. Lichen spinulosus is an uncommon condition, usually presenting in childhood, which is characterised by multiple rough, spiny papules that are grouped together in patches or. Lichen planopilaris lpp is a rare inflammatory scalp disorder characterised by scarring alopecia permanent hair loss with several different patterns. It is a variant of keratosis pilaris named for its resemblance to a patch of lichen. Dear editor, lpp is one of the main causes of primary cicatricial alopecias. In this report the clinical and histologic data of 35 patients with lichen spinulosus are presented. Lichen scrofulosorum, also known as tuberculosis cutis lichenoides, is a rare tuberculid that presents as a lichenoid eruption of minute papules in children and adolescents with tuberculosis. It is characterised by solitary or multiple patches of minute follicular papules, each centred. Lichen planopilaris lpp is an inflammatory condition that causes patchy hair loss, mainly on the scalp. Since then, few other similar reports were published until 1990, when friedman presented data on 35 patients with lichen spinulosus. There have been no wellcontrolled trials documenting the benefit of any therapy in lpp. Lichen planopilaris lpp is a cellmediated scarring alopecia that causes inflammation of the scalp and the eventual destruction of hair follicles in affected areas.
Lichen spinulosus is not dangerous and is not associated with any abnormalities of other organ systems. Lichen pilaris seu spinulosus of crocker springerlink. In 1883, crocker described a peculiar follicular keratosis with acute onset under the title acute lichen pilaris spinulosus, occurring in irregular patches symmetrically arranged, in which the papules were pinhead sized, of normal skin color, evidently located about the hair follicles, with a spiny projection of horny epithelium. Lichen spinulosus definition of lichen spinulosus by. It is characterized by follicular hyperkeratotic papules that may coalesce into plaques. Common symptoms may include lacywhite lesions in the mouth, which may cause. A read is counted each time someone views a publication summary such as the title, abstract, and list of authors, clicks on a figure, or views or downloads the fulltext. The cause is unknown, but lichen spinulosus may be triggered by infection, genetics, or allergies. It commonly develops in association with lichen planus affecting the skin, mucosa and nails. The lesions are usually asymptomatic, closely grouped, skincolored to reddishbrown papules, often perifollicular, and are mainly found on the abdomen. Lichen pilaris synonyms, lichen pilaris pronunciation, lichen pilaris translation, english dictionary definition of lichen pilaris. Get a printable copy pdf file of the complete article 157k, or click on a page image below to browse page by page.
With respectto lichen pilaris seu spinulosus crocker, there are many recorded. Lichen planopilaris british association of dermatologists. This page may contain content that is offensive or inappropriate for some readers. Lichen planus medical definition merriamwebster medical. Lichen planopilaris is a type of scarring hair loss that occurs when a relatively common skin disease, known as lichen planus, affects areas of skin where there is. We report on our histological experience in 47 patients with lichen planopilaris frontal fibrosing alopecia. Lichen spinulosus primary care dermatology society uk. About a third of all people who have oral lichen planus also have skin lichen. Carolines story of lichen planopilaris lucinda ellery. Differentiating lichen spinulosus from keratosis pilaris by microscopy may not. Lichen planopilaris lpp, a follicular form of lichen planus, is a rare inflammatory lymphocytemediated disorder that selectively involves hair.
Little information is available concerning the clinical course of lichen planus and its variations. The full text of this article is available in pdf format. Individual lesion shows conical projection, hair like horny spine. However, the age of the patient, the course, and especially the pathological changes distinguish these from follicular lichen planus.
It has been described as a type offollicular reaction1. Lichen planopilaris usually affects young adult women, although the age range is wide and it also affects men. It is a form of lichen planus that most often affects women in young adulthood. The true follicular disorders can have two clinical presentations, either keratotic papules or papules with prominent spines. Lichen pilaris definition of lichen pilaris by the free. The common disorders seen on the face include keratosis rubra pilaris, erythromelanosis follicularis, dariers disease, pityriasis rubra pilaris, phrynoderma, follicular dermatitis, and lichen spinulosus.
It is characterised by solitary or multiple patches of minute follicular papules, each centred by a horny spine, which may occur on any part of the body. It is between 2 and 5 times more common in women than it is in men and is seen mostly in. Lichen pilaris article about lichen pilaris by the free. Lichen planopilaris lpp, a follicular form of lichen planus, is a rare inflammatory lymphocyte mediated disorder. The variations and course of lichen planus jama dermatology. Keratosis pilaris kp is a very common skin condition that results in the formation of small bumps on the skin, usually on the arms and legs. Lichen spinulosus is an uncommon dermatosis manifested by large patches of follicular papules topped by keratotic spines, as shown below.
There are 3 forms of lpp, distinguished by specific patterns and locations of symptoms. Lichen pilaris definition of lichen pilaris by medical. Lichen planopilaris is a type of scarring hair loss that occurs when a relatively common skin disease, known as lichen planus, affects areas of skin where there is hair. Although follicular lp and dle can be seen in the same patient, this is very. Lichen planopilaris symptoms, causes, treatment, diagnosis, pictures, photos and images in mouth, throat, nails, eyes, hair loss. G lichen spinulosus et folliculitis decalvans, proc. If you have problems viewing pdf files, download the latest version of adobe reader. Lichen pilaris appears in two to threeyearold children, reaches it height between 15 and 20. Before and after pictures of caroline my story began about five years ago. Lichen planus is a common skin rash that is not contagious. Lichen planopilaris lpp, also referred to as follicular lichen planus lp, lichen follicularis, and lichen planus acuminatus, is characterized by perifollicular erythema and scale that can progress to cicatricial scarring alopecia over time. Lichen planopilaris destroys the hair follicle and then replaces it with scarring. Oral lichen planus is more difficult to treat and typically lasts longer than skin lichen planus. As in lichen planus, lpp is thought to be caused by dysfunction in cellmediated immunity.
In 1883, crocker described a peculiar follicular keratosis with acute onset under the title acute lichen pilaris spinulosus, occurring in irregular patches symmetrically arranged, in which the papules were pinhead sized, of normal skin color, evidently located about the hair follicles, with a. Differentiation from discoid lupus erythematosus dle of the scalp can sometimes be difficult. Abstract lichen planopilaris lpp and frontal fibrosing alopecia ffa are lymphocytic scarring alopecias affecting primarily the scalp. Lichen planopilaris usually produces multifocal areas of scarring alopecia. We report on our histological experience in 47 patients with lichen planopilarisfrontal fibrosing alopecia. It is characterized by polygonal, flattopped, violaceous papules and plaques with overlying, reticulated, fine white scale wickhams striae, commonly affecting dorsal hands, flexural wrists and forearms, trunk, anterior lower legs and oral mucosa.
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