Central Centrifugal Cicatricial Alopecia and Lichen Planopilaris Can Look Identical on Histopathology.

Central centrifugal cicatricial alopecia (CCCA) and lichen planopilaris (LPP) can look identical on histopathology. Both entities demonstrate perifollicular fibrosis, peri- infundibular lymphocytic infiltrates, and reduced follicular density. Presence of normal follicular units and preservation of sebaceous glands favor CCCA. An elastin stain, that is, Verhoeff-Van Gieson stain, can differentiate the tree trunk fibrosis of CCCA from the narrow wedge-shaped fibrosis of LPP. Look for important clues such as patient race and pattern of alopecia for diagnosis and treatment instead of relying solely on the pathology report.