Vascular Proliferation in Biopsies from Active Lichen Planopilaris as a Novel Pathologic Finding

This study identifies a novel vascular finding in lichen planopilaris (LPP), a type of scarring alopecia, characterized by plexiform-like erythema observed through trichoscopy. The research involved 3 patients with biopsy-proven LPP, revealing increased angiogenesis and vascular proliferation in affected scalp areas. These findings suggest that the presence of plexiform erythema may indicate active disease and necessitate aggressive treatment to prevent progression. The study highlights the role of angiogenesis in LPP's pathogenesis, driven by inflammatory mediators, and emphasizes the importance of histological evaluation to distinguish LPP from other conditions like cutaneous angiosarcoma. Further research with dermoscopy-guided biopsies is recommended to validate these findings.