雄激素性秃发区域的扁平苔藓样毛发角化病：毛发移植的一个陷阱。
Lichen Planopilaris in the Androgenetic Alopecia Area: A Pitfall for Hair Transplantation.
作者信息
Baquerizo Nole Katherine L, Nusbaum Bernard, Pinto Giselle M, Miteva Mariya
机构信息
Department of Dermatology, Miller School of Medicine, University of Miami, Miami, Fla., USA.
Hair Transplant Institute of Miami, Coral Gables, Fla., USA.
出版信息
Skin Appendage Disord. 2015 Mar;1(1):49-53. doi: 10.1159/000381588. Epub 2015 Apr 23.
BACKGROUND
Classic lichen planopilaris (LPP) is a patchy form of primary lymphocytic cicatricial alopecia localized on the vertex of the scalp. It is important, however, to be aware of other, less recognized presentations that may be missed without dermatoscopy and pathology.
METHODS AND RESULTS
We report 26 patients with LPP presenting with subtle erythema and scaling colocalized in the area of patterned thinning (androgenetic alopecia, AGA). All patients had been treated for seborrheic dermatitis in the past. Dermatoscopy showed the presence of 2-4 hairs emerging as a tuft from the same ostium surrounded by erythema, peripilar casts and interfollicular scaling associated with hair miniaturization. Histopathology obtained from those areas corresponded to LPP with concomitant follicular miniaturization.
CONCLUSION
Subtle or focal cases of LPP may be missed for seborrheic dermatitis when overlapping with AGA. Dermatoscopy-guided biopsy from the affected scalp is the best approach to make a timely diagnosis. This is particularly important in patients with AGA evaluated to undergo hair transplantation, as active LPP is a contraindication for these patients.
背景
经典扁平苔藓样毛发角化病（LPP）是原发性淋巴细胞性瘢痕性脱发的一种斑片状形式，局限于头皮顶部。然而，重要的是要意识到其他一些不太被认可的表现，如果没有皮肤镜检查和病理学检查，这些表现可能会被遗漏。
方法与结果
我们报告了26例LPP患者，其在有模式性变薄（雄激素性脱发，AGA）的区域出现细微红斑和鳞屑。所有患者过去均接受过脂溢性皮炎治疗。皮肤镜检查显示有2 - 4根毛发从同一毛囊口成簇长出，周围有红斑、毛周角质鞘和与毛发小型化相关的毛囊间鳞屑。从这些区域获取的组织病理学检查结果符合LPP并伴有毛囊小型化。
结论
当LPP与AGA重叠时，其细微或局灶性病例可能会被误诊为脂溢性皮炎。在受影响的头皮进行皮肤镜引导下活检是及时做出诊断的最佳方法。这对于评估要进行毛发移植的AGA患者尤为重要，因为活动性LPP是这些患者的禁忌证。
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