Trichoscopy in lichen planopilaris: an update

The most common trichoscopic features of classic lichen planopilaris include (in order of frequency) the absence of follicular openings, perifollicular scaling, white cicatricial areas and perifollicular erythema. By comparison, the most common trichoscopic findings of frontal fibrosing alopecia are (in order of frequency) perifollicular scaling, the absence of follicular openings, perifollicular erythema and white cicatricial areas. Milky-red areas are a common feature of classic lichen planopilaris which is not observed in frontal fibrosing alopecia. Other trichoscopic findings of both classic lichen planopilaris and frontal fibrosing alopecia include blue-grey and classic white dots. Additionally, in fibrosing alopecia in a pattern distribution, hair shaft thickness diversity is observed. Dermoscopic features of frontal fibrosing alopecia in the eyebrow area include follicular red dots, grey dots, black dots, yellow dots, diffuse erythema, broken hairs, short regrowing hairs and the absence of follicular openings. Other non-scalp lichen planopilaris lesions are characterized by a dermoscopic pattern similar to the one observed on the scalp.