Facial Lichen Planopilaris Mimicking Melasma: A Case Report Emphasizing the Value of Clinicopathologic Correlation.

Authors

Maryam Hekmat, Negin Fazelzadeh Haghighi, Fatemeh Sari Aslani, Farideh Jokar

Published in

Case reports in dermatological medicine. Volume 2026. Pages 1703880. Epub Jun 28, 2026.

Abstract

Lichen planopilaris (LPP) is a rare, immune-mediated cicatricial alopecia characterized by perifollicular erythema, hyperkeratosis, and progressive hair follicle destruction, leading to permanent hair loss. While LPP typically affects the scalp and is classified into classic LPP, frontal fibrosing alopecia (FFA), and Graham-Little-Piccardi-Lassueur (GLPL) syndrome, atypical presentations involving extra-scalp regions, including the face, are exceedingly rare. We present a unique case of melasma-like LPP manifesting on the face, a highly unusual presentation that posed diagnostic challenges due to its resemblance to hyperpigmentary disorders. A 38-year-old man presented with an asymptomatic hyperpigmented patch on the cheek and forehead mimicking melasma. This case highlights the importance of considering LPP in the differential diagnosis of facial hyperpigmentation, particularly when conventional therapies for melasma fail. It should be noted that histopathology was a valuable tool for the diagnosis of the disease. We recommend including dermoscopic images in future studies to help dermatologists become familiar with the dermoscopic features of LPP and to differentiate between LPP and melasma using dermoscopy.

PMID:
42371518
Bibliographic data and abstract were imported from PubMed on 29 Jun 2026.

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