A Graham-Little-Piccardi-Lassueur syndrome accompanied by lichen planus pigmentosus

Graham-Little-Piccardi-Lassueur syndrome (GLPLS) is a rare variant of lichen planopilaris characterised by non-cicatricial hair loss of pubis and axilla, keratotic papules that are like keratosis pilaris follicles located on the trunk and extremities and cicatricial alopecia on the scalp [1]. However, it is not necessary for these three features to coincide. In this case, we aimed to present a 58-year-old patient with GLPLS accompanied by lichen planus pigmentosus unlike the usual GLPLS.
A 58-year-old woman admitted to the hospital with a 2 years’ history of pruritus and spots which began on the scalp and axilla and then spread to the neck and chest. Shortly after these complaints, she reported alopecia involving her scalp, axillae and genitalia. She was postmenopausal for 5 years. She did not have any problem in her past medical history and family history. She was not taking any medication. Dermatological examination revealed locally brown and erythematous reticular patches on the axilla and both lateral necks and under the breasts. There were rare vellus type hair on the scalp, axilla and genital area without atrophy and nails were natural. Oral mucosa, genital mucosa and other system examinations were normal. Her laboratory findings including hemogram and biochemical values were also normal. The biopsies were taken from the lesions on the scalp and trunk with a pre-diagnosis of lichen planus. Histopathological examination revealed superficial perivascular, lichenoid interphase changes and melanophages in the lesion taken from the trunk and perifollicular lymphocytic infiltration in the lesion taken from the scalp. The patient was diagnosed as GLPLS according to the clinical and histopathological evaluation. After diagnosis, the patient received acitretin 25 mg/day and also topical hydrocortisone butyrate 2 × 1 therapy for the trunk lesions (Figures 1, 2).
At 3-month follow-up of the patient, we determined the regression of the lesions on the axilla, both lateral necks and under the breasts with a post inflammatory pigmentation.
The disease was originally defined in 1914 by Piccardi, who described a case of progressive cicatricial scalp alopecia, non-cicatricial alopecia in the axilla and pubic area, and follicular papules on the trunk and extremities [2]. Later, in 1915, Graham Little published a similar condition defined as “folliculitis decalvans et atrophicans”. For this reason, the disease is called as GLPLS. The disease is...


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