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Folliculitis decalvans and lichen planopilaris phenotypic spectrum: a case series of biphasic clinical presentation and theories on pathogenesis
Author(s) -
Yip L.,
Barrett T. H.,
Harries M. J.
Publication year - 2020
Publication title -
clinical and experimental dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.587
H-Index - 78
eISSN - 1365-2230
pISSN - 0307-6938
DOI - 10.1111/ced.13989
Subject(s) - dermatology , folliculitis , scarring alopecia , pathogenesis , medicine , phenotype , hair follicle , microbiome , dysbiosis , pathology , alopecia areata , immunology , biology , bioinformatics , disease , scalp , gene , biochemistry
Summary We present a series of 13 patients with clinical and histological features of both folliculitis decalvans ( FD ) and lichen planopilaris ( LPP ), either concomitantly, or sequentially as the clinical phenotype changed over time. This biphasic presentation of FD ‐ LPP is not as uncommon as would be expected from the lack of description in the literature. We discuss current theories about the pathogenesis of both LPP and FD , and speculate how abnormal immune responses may either predispose to secondary bacterial infection or be influenced by dysbiosis of the skin/hair follicle microbiome, resulting in inflammation and permanent hair follicle damage.