Lichen Planopilaris Versus Frontal Fibrosing Alopecia: Histopathologically Distinct Diseases or Not?

This study examines whether lichen planopilaris (LPP) and frontal fibrosing alopecia (FFA) are distinct diseases or variations of the same condition. Analyzing 42 LPP and 19 FFA cases, the research found that both conditions show perifollicular lichenoid inflammation and fibrosis. However, LPP is marked by more extensive epidermal and dermal lymphocytic infiltration, while FFA has more follicle-centered inflammation and higher follicular miniaturization, possibly linked to androgenetic alopecia. The findings suggest that LPP and FFA may be distinct diseases with similar lymphocyte-mediated reactions but differ in tissue involvement, indicating a need for further research to clarify their relationship and develop targeted treatments.