Lichen planopilaris [cicatricial (scarring) alopecia] in a child.

A mother of a 12‐year‐old boy, 2 years ago, noticed that he showed patchy loss of hair on the vertex of the scalp. It was asymptomatic and progressive. Subsequently, similar patches appeared elsewhere on the scalp. Some of these patches joined to form a large bald patch. This was accompanied by dusky blue eruptions over the left upper lip and eyebrows. Later, there was localized loss of hair. A family history of a similar ailment was absent. Examination of the scalp revealed plaques of alopecia with mild to moderate erythema. The skin was smooth, shiny, and atrophic ( Fig. 1 ). Atrophy was apparent by the presence of wrinkles in places, and by holding the skin between the thumb and the index finger. The periphery of the lesions was well demarcated and was occupied by erythematous, scaly, follicular papules. Lesions were also located on the patches of alopecia. In addition, flat‐topped, dusky blue, papules/plaques were present over the upper lip.

Figure 1 Open in figure viewer PowerPoint Lichen planopilaris: plaques of alopecia showing smooth, shiny, atrophic skin with erythema