Lichen Planopilaris After Hair Transplantation: Report of 17 Cases

BACKGROUND: Lichen planopilaris (LPP) is a type of primary scarring alopecia. The pathogenesis is poorly understood, although traumatic skin injury has been implicated in some cases. OBJECTIVE: To present 17 patients diagnosed with LPP after hair transplant surgery. MATERIALS AND METHODS: A retrospective review of the records of patients referred for evaluation of suboptimal growth after hair transplantation and diagnosed with LPP. Patients' scalps were evaluated using dermoscopy, and scalp biopsies were performed in all patients to confirm the diagnosis of LPP. DISCUSSION: Seventeen patients (15 male, 2 female) were diagnosed with LPP after hair transplant surgery. The timing of disease occurrence was variable--4 to 36 months after hair transplantation. The most common symptom was itching. Perifollicular erythema or perifollicular scale, the classical dermatoscopic signs of LPP,was present in 12 patients (70%). CONCLUSION: These data provide further support for an association between hair transplant surgery and the development of LPP. Traumatic skin injury from recipient site creation may be relevant to the pathogenesis. The incidence of this phenomenon and risk factors remain to be clarified.