Coexistence of Alopecia Areata, Lichen Planopilaris, and Lichen Planus Pigmentosus: A Case Report

This case report discusses a 37-year-old woman with the rare coexistence of alopecia areata, lichen planopilaris, and lichen planus pigmentosus. The patient experienced diffuse non-scarring alopecia, scar-like patches, and loss of body hair. Trichoscopy and biopsies revealed distinct characteristics of each condition, such as follicular miniaturization and interface folliculitis. Treatment with monthly intravenous corticosteroid pulses and weekly methotrexate stabilized the condition and led to slight regrowth of scalp and eyebrow hair after one year, although pigmentation changes persisted. The report highlights the importance of examining different scalp zones separately and targeting active areas for biopsy, as scarring and non-scarring alopecias may coexist and require different treatment approaches.