Lichen Planopilaris in Children: A Systematic Review.

Background: Lichen planopilaris (LPP) is the most common form of scarring alopecia in adults. The disease may also occur in children and adolescents. The aim of this systematic review is to evaluate clinical, trichoscopic, and histopathologic features of pediatric LPP. Therapeutic management is also discussed.

Methods: The systematic review was performed according to preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines by searching PubMed, Scopus, and EBSCO databases with the last search on June 18, 2024.

Results: A total of 12 studies including 20 children were analyzed. Male predominance was observed. The typical presentation of LPP in children included scarring, perifollicular erythema, scaling, and plugging; atrophy, and follicular hyperkeratotic papules, located most commonly in the vertex. The most common trichoscopic findings were scaling and blue-gray dots, perifollicular erythema, and the absence of follicular ostia. Histopathological examination revealed perifollicular fibrosis, perifollicular interface lymphocytic inflammation, pigment incontinence, cytoid bodies, and scarring in the dermis. Complete or partial response was observed in children treated with topical, intralesional, and systemic corticosteroids, methotrexate, pioglitazone, and tocilizumab.

Conclusions: LPP is a rare cause of scarring alopecia in children. The disease should be taken into consideration in the differential diagnosis of patchy hair loss in children.