Abstract
INTRODUCTION: Lichen planopilaris (LPP) is a well-known cicatricial alopecia with a frontal fibrosing variant. LPP has a prevalence rate of 13.4 per 100,000 persons. It is understood that LPP favors the female populations. What is not commonly known is that LPP can be preceded by other signs and symptoms such as pili torti. CASE REPORT: We present a case report of a 70-year-old female whose initial flare of LPP was preceded by a flare of pili torti. This patient's case is also complicated by her history of ectodermal dysplasia. She experienced progressive itching, shedding, and mid-scalp hair loss along with brittle curls which failed to improve with intralesional steroids and minoxidil, which prompted further investigation. CONCLUSION: This case highlights how early intervention and detection can allow for treatment and prevention of further hair loss in patients with LPP and as well as other alopecias. Treatment of patients at onset of disease is crucial to prevent permanent hair loss.