Abstract

Background:  Lichen Planopilaris (LPP) and Central Centrifugal Cicatricial Alopecia (CCCA) have many histopathologic similarities. Fung et al. and Kazlouskaya et al. have noted that the Verhoeff-Van Gieson (VVG) staining pattern can differentiate the two entities through visualization of either a superficial wedge-shape or tree trunk fibrosis pattern. To further elucidate the differences, looking at patient demographic data is also warranted.

Methods: A retrospective study was performed for patients diagnosed with either LPP or CCCA by elastin staining pattern between 2019 and 2023. Cases with concurrent androgenetic alopecia (AGA) were excluded. Those remaining were further classified by age and race. An independent T-test was used to analyze age at diagnosis.

Results: Of the 42 cases identified, 37 were diagnosed as LPP and 6 were diagnosed as CCCA. Of the 37 LPP cases, 32 patients were black, 4 were white and 1 was asian. The ages ranged from 32 to 86 with an average age of 53. Of the 6 CCCA cases, all 6 were black. The ages ranged from 26 to 66 with an average age of 42. The CCCA group was younger in age than the LPP group (p-value=0.0266).

Conclusion: The analysis revealed a difference in age between LPP and CCCA patients after excluding concurrent AGA, leaving open the possibility that LPP and CCCA are clinically distinct entities. It suggests CCCA can be attributed to lifestyle, grooming habits, and genetics. It also suggests VVG can diagnose LPP and CCCA more consistently than routine stains alone.