Lichen planopilaris
The most common trichoscopic features of classic lichen planopilaris include the absence of follicular openings, perifollicular scaling and white cicatricial areas. Other common trichoscopic findings are perifollicular erythema, milky-red areas, classic white and blue-grey dots (1, 2) (3).
In frontal fibrosing alopecia, perifollicular scaling, the absence of follicular openings, perifollicular erythema, white cicatricial areas, blue-grey and classic white dots are most commonly observed (1, 2). Milky-red areas are not observed in trichoscopic examination (2).
Perifollicular scaling and perifollicular erythema are considered as markers of disease activity. Perifollicular erythema and white cicatricial areas are associated with disease severity (1).
| Trichoscopic Feature | Classic lichen planopilaris Mean frequency in %* (reported prevalence**) |
Frontal fibrosing alopecia Mean frequency in %* (reported prevalence**) |
|---|---|---|
| Perifollicular erythema | 43 (0 – 88) | 68 (0 – 100) |
| Perifollicular scaling | 85 (38 – 100) | 84 (42 – 90) |
| Classic white dots | 32 (0 – 100) | 13 (0 – 50) |
| Milky-red areas | 33 (14 – 100) | Not reported |
| White cicatricial areas | 84 (0 – 100) | 26 (20 – 100) |
| Absence of follicular openings | 99 (75 – 100) | 82 (52 –100) |
| Blue-grey dots | 32 (0 – 56) | 25 (0 – 50) |
Trichoscopy of lichen planopilaris with presence of perifollicular, white scaling and milky-red areas with absence of follicular openings.
