Patchy Hair Loss, Hyperpigmented Plaques, and Hyperkeratotic Papules in a Middle-Aged Woman

Little-Graham-Piccardi-Lassueur-Syndrome (LGPLS) is a rare condition characterized by cicatricial alopecia of the scalp, non-scarring alopecia of the axillae and perineum, and hyperkeratotic follicular eruptions. A 53-year-old woman presented with symptoms consistent with LGPLS, including severe pruritus, progressive hair loss, and erythematous plaques. Examination and trichoscopy confirmed the diagnosis, revealing irregular alopecic areas and follicular plugging. Histopathology showed a lichenoid infiltrate, confirming lichen planus and lichen planopilaris. Treatment included oral prednisone, topical clobetasol, hydroxychloroquine, methotrexate, folic acid, topical tacrolimus, and minoxidil. The patient responded well to treatment, with no progression of the dermatosis.