Comedone-Like Lesions as a Manifestation of Lichen Planopilaris beyond the Scalp: A Case Report with Dermoscopic Features and Literature Review

Abstract

Lichen planopilaris is a rare inflammatory condition that is also known as follicular lichen planus. Although the condition commonly affects the scalp, it sometimes involves the other regions of the body with a variety of clinical presentations. The involvement beyond the scalp is considered to be a generalized nature of disease process. In this report, we present a case of generalized follicular lichen planus in a 34-year-old Thai female presenting with comedone-like lesions on the trunk and extremities as well as scarring alopecia on the scalp. Dermoscopic features were also discussed.

Widespread and eruptive comedonal lesions with alopecia

“…Graham Little syndrome is a rare variant of lichen planopilaris, which is characterized by progressive patchy scarring alopecia of the scalp, nonscarring alopecia of the axilla and groin, and a follicular lichen planus eruption on the body that affects middle-aged postmenopausal women. 3 Histopathology includes follicles and cysts surrounded by a lichenoid lymphocytic infiltrate in the absence of atypical lymphocytes. Contrary to the case of our patient, neither infiltrate nor plaque-like lesions with epidermotropic infiltrate were present.…”