Abstract:Lichenoid disorders are inflammatory disorders characterized clinically by flat‐topped, papular lesions and histologically by a lymphocytic infiltrate with a band‐like distribution in the papillary dermis. This group of conditions includes lichen planus, lichen planopilaris, lichen nitidus and keratosis lichenoides chronica, among others.
Papulosquamous diseases are characterized by well-demarcated areas of papules and scale, typically on an erythematous background. The differential diagnosis includes psoriasis, lichen planus, mycosis fungoides, discoid lupus erythematosus, eczema/dermatitis, drug eruptions, tinea, pityriasis versicolor, secondary syphilis, and pityriasis rosea. The presence of significant pruritus is a useful marker to help with the differential diagnosis: lichen planus and discoid eczema are typically pruritic, whereas others, such as psoriasis, are less so. The distribution is also key to diagnosis, with psoriasis often showing characteristic symmetrical involvement of the extensor surfaces, scalp, and nails. Histology can be essential to reach a diagnosis and plan an appropriate approach to management.
The term cicatricial alopecia results from irreversible damage to epithelial stem cells located in the bulge region of the hair follicle with subsequent scarring. Based on the mechanism involved in follicular destruction, cicatricial alopecia is divided into primary and secondary forms. Primary cicatricial alopecia are divided into four groups according to their prominent inflammatory infiltrate: with lymphocytic, neutrophilic, mixed or nonspecific cell inflammation pattern.
The review presents the main clinical, histological and dermatoscopic signs of various types of primary cicatricial alopecia.
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