INTRODUCTION
Lichen planopilaris (LPP) is a primary scarring alopecia and a follicular version of lichen planus (LP), which can present in association with LP or more often presents alone.1 Androgenetic alopecia is a nonscarring alopecia with a genetic predisposition that leads to pattern baldness.2 In males, it classically begins with bitemporal thinning of the frontal scalp and can involve the vertex while women can present with vertex and frontal scalp involvement.2 Trichoscopy, or scalp dermoscopy, findings can differ in skin of color requiring a dedicated approach to ensure adequate examination to provide proper diagnosis and treatment.3-4 This case series details three cases of concurrent lichen planopilaris (LPP) and female androgenic alopecia (FAGA) in the skin of color.
Case 1
A 52-year-old Black female with a past medical history significant for lupus, depression, and iron deficiency anemia presented to the office with several years of hair loss and recently acquired "bald spots." Her hair loss was reported to be exacerbated by stress. She denied any scalp itching, dryness, pain, or flaking, and denied loss of hair on other parts of her body. In the past, she has had tight braids but removed them because of migraines. Examination revealed moderate thinning at the frontal scalp (Figure 1A) with trichoscopy of the region revealing perifollicular scale, mild erythema, and interruption of honeycomb pattern with the presence of vellus hairs (Figure 1C). Examination of the temporal scalp revealed mild hair density thinning with diffuse hair follicle miniaturization with the presence of pinpoint white dots and brown halos around the hair follicles (Figure 1D). Differential diagnoses included FAGA, cutaneous lupus, diffuse alopecia areata, or traction alopecia exacerbated by telogen effluvium. Due to the differences in trichoscopy findings, two 4 mm
Case 1
A 52-year-old Black female with a past medical history significant for lupus, depression, and iron deficiency anemia presented to the office with several years of hair loss and recently acquired "bald spots." Her hair loss was reported to be exacerbated by stress. She denied any scalp itching, dryness, pain, or flaking, and denied loss of hair on other parts of her body. In the past, she has had tight braids but removed them because of migraines. Examination revealed moderate thinning at the frontal scalp (Figure 1A) with trichoscopy of the region revealing perifollicular scale, mild erythema, and interruption of honeycomb pattern with the presence of vellus hairs (Figure 1C). Examination of the temporal scalp revealed mild hair density thinning with diffuse hair follicle miniaturization with the presence of pinpoint white dots and brown halos around the hair follicles (Figure 1D). Differential diagnoses included FAGA, cutaneous lupus, diffuse alopecia areata, or traction alopecia exacerbated by telogen effluvium. Due to the differences in trichoscopy findings, two 4 mm
