PMC5726685_01
Bilateral frontoparietal alopecia and eyebrow rarefaction
abd-92-05-s1-0079-g01.jpg
PMC5726685_01_abd-92-05-s1-0079-g01.jpg
f1
On examination, bilateral frontoparietal plaques of alopecia, and eyebrow (Figure 1) and axillary hair rarefaction were observed.
Biopsy of the plaque showing perifollicular fibrosis and lymphocytic
infiltration in a lichenoid pattern around the follicle infundibulum and
isthmus Hematoxylin & eosin, (X400)
abd-92-05-s1-0079-g02.jpg
PMC5726685_01_abd-92-05-s1-0079-g02.jpg
f2
Histopathology of the biopsy taken from the plaque revealed a pattern of scarring alopecia consistent with FFA (Figure 2).
Dermoscopy of the alopecic plaque showing reduced follicular openings and
perifollicular hyperkeratosis (X20)
abd-92-05-s1-0079-g03.jpg
PMC5726685_01_abd-92-05-s1-0079-g03.jpg
f3
The pull test was positive and dermoscopy of the plaque revealed a scarring pattern, hair rarefaction, isolated hairs on the frontal hairline, hyperkeratosis, and blue-grey perifollicular hyperpigmentation (Figure 3).
Hyperpigmentation on the anterior cervical region
abd-92-05-s1-0079-g04.jpg
PMC5726685_01_abd-92-05-s1-0079-g04.jpg
f4
Subsequently, prednisone in an anti-inflammatory dose was prescribed, along with systemic tetracycline and topical betamethasone, but the patient continued with clinical hyperpigmentation on the anterior cervical region and perifollicular hyperpigmentation seen on dermoscopy in areas of the scalp, periocular and cervical regions (Figure 4).
Biopsy from a cervical hyperpigmented macule with focal interface
dermatitis with superficial dermal melanosis, pigmentary incontinence
and presence of melanophages (arrows) Hematoxylin & eosin,
(X400)
abd-92-05-s1-0079-g05.jpg
PMC5726685_01_abd-92-05-s1-0079-g05.jpg
f5
A biopsy was taken from a cervical hyperpigmented macule, and the histopathology revealed focal interface dermatitis with superficial dermal melanosis and pigmentary incontinence, consistent with LPP (Figure 5).