Perda pilosa por líquen plano pilar após transplante capilar: relato de dois casos e revisão da literatura

Abstract

Androgenetic alopecia is often treated by follicular unit transplantation, a technique that involves minimal risk of hair loss because of the more resistant nature of the donor area. Lichen planopilaris is a cicatricial alopecia that causes permanent destruction of hair follicles. We report two cases of post-transplantation lesions compatible with lichen planopilaris in both recipient and donor areas. The quality of the hair follicles in the donor area was apparently compromised by lichen planopilaris, the probable cause of hair loss. Similar reports are rare. When lichen planopilaris is suspected, a biopsy of the scalp must be performed to avoid transplantation during disease activity. Keywords: Alopecia; Lichen planus; Transplantation; Transplantation, autologous Resumo: Alopecia androgenética é tratada com frequência por meio de microtransplante capilar, téc-nica em que os fios transplantados geralmente não caem, pois mantêm características da área doadora, mais resistente. O líquen plano pilar é uma alopecia cicatricial com permanente destruição pilosa. Este artigo relata dois casos de lesões compatíveis com líquen plano pilar em áreas receptora e doadora pós-transplante. A dominância da área doadora foi aparentemente sobrepujada pelo líquen plano pilar, que deve ter gerado a queda dos fios. Relatos semelhantes são raros. À suspeita de líquen plano pilar, devese biopsiar o couro cabeludo e evitar o transplante durante a atividade da doença.

Frontal fibrosing alopecia: reflections and hypotheses on aetiology and pathogenesis

“…The observation that hair transplantation and facelift surgery reactivates the disease process may also be in keeping with the above hypothesis: the disordered immune‐mediated collapse of the hair follicle's privileged integrity may well leave local factors, such as memory T cells in skin stroma. In line with this, when apparently normal autologous hair follicles are transplanted to a region previously involved with FFA, subjects can develop the histological hallmarks of the disease .…”

Cutaneous and Mucosal Lichen Planus: A Comprehensive Review of Clinical Subtypes, Risk Factors, Diagnosis, and Prognosis

“…LPP can also be induced by hair transplantation or face-lift surgery. The possible triggering factors include the Koebner phenomenon, perisurgery antigen release, or the postoperative immune-inflammatory response [45, 46]. “Fibrosing alopecia in a pattern distribution” is another suggested subtype that has a centroparietal pattern.…”

Frontal Fibrosing Alopecia: A Review

“…Some cases of FFA or LPP developed after hair transplantation for AGA, so hair transplants may also be affected [ 8 , 90 , 91 ]. In addition, one female developed FFA after face lift surgery [ 91 ].…”