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What is PIILIF?

Published on July 10, 2024. Last Updated on July 10, 2024.

What is PIILIF (Perifollicular Infundibulo-Isthmic Lymphocytoplasmic Infiltrates and Fibrosis)? It is a dermatological condition characterized by inflammation of hair follicles, hair loss, and scalp scarring. Recent research suggests that the condition affects scalp hair and other non-scalp hair follicles. In rare cases, PIILIF might attack eyebrows, eyelashes, beards, and the pubic regions.

Specialists presume many body and scalp conditions cause PIILIF. It manifests as Cicatricial Alopecia (scarring hair loss) and small bumps around hair follicles.

Perifollicular Infundibulo-Isthmic Lymphocytoplasmic Infiltrates and Fibrosis is often ignored and mistaken for seborrheic dermatitis or dandruff, especially in cases where patients fail to manifest clinical symptoms.

What Causes PIILIF?

Researchers have not yet established the leading cause of Perifollicular Infundibulo-Isthmic Lymphocytoplasmic Infiltrates and Fibrosis. However, several factors are believed to cause the condition either as a standalone condition or as a precursor to other Cicatricial Alopecias.

The factors are:

  • Genetics. In general, people with a family history of developing dermatological, inflammatory, or hair conditions can be vulnerable to Perifollicular Infundibulo-Isthmic Lymphocytoplasmic Infiltrates and Fibrosis.
  • Immune System Imbalance. When the immune system attacks healthy hair follicles, a patient might experience some follicular conditions. Perifollicular Infundibulo-Isthmic Lymphocytoplasmic Infiltrates and Fibrosis can develop as a precursor condition that, in later stages, manifests as such conditions.
  • Hormones. Research is still being conducted to ascertain the link between hormones and Perifollicular Infundibulo-Isthmic Lymphocytoplasmic Infiltrates and Fibrosis. An imbalance in hormones related to hair growth and skin can lead to the development of PIILIF.  
  • Underlying Conditions. Follicular inflammation and scarring hair conditions such as Acne Keloidalis Nuchae (AKN), Folliculitis Decalvans (FD), Lichen Planopilaris (LPP), and Frontal Fibrosing Alopecia (FFA) can trigger the development of Perifollicular Infundibulo-Isthmic Lymphocytoplasmic Infiltrates and Fibrosis in their early stages.
  • Environmental Triggers. Exposure to chemicals, allergens, or pollutants, as well as trauma or scalp injuries, can trigger the development of Perifollicular Infundibulo-Isthmic Lymphocytoplasmic Infiltrates and Fibrosis.

Contexts Where Can PIILIF Be Found

Primary Condition

A doctor can diagnose PIILIF as a standalone condition with histopathological features and symptoms such as fibrosis, inflammation, and hair loss, however, it does not necessarily indicate the presence of other underlying conditions.

Precursor to other conditions

In some cases, PIILIF can be an initial stage in the development of other inflammatory or dermatological conditions, such as Acne Keloidalis Nuchae (AKN) and Foliculitis Decalvans (FD).

PIILIF Shared Precursor Condition for Acne Keloidalis Nuchae (AKN) and Primary Cicatricial Alopecias (PCAs)

Understanding the relationship between PIILIF and other Primary Cicatricial Alopecias (PCAs) can help diagnose and manage the conditions early to prevent progression.

A research study by Dr. Sanusi Umar, conducted on 41 male patients suffering from AKN, showed symptoms and signs of PIILIF. Moreover, the signs were also exhibited on the Normal-appearing scalp (NAS), away from the AKN lesions. The findings further highlighted the presence of scarring, inflammation, and scaling on some of the patients’ beards and other hairy body parts. This was evidence that PIILIF is a scalp condition and affects hair follicles in different body parts.

An illustration of PIILIF as a shared precursor condition to Primary Cicatricial Alopecias (PCAs).
An illustration of PIILIF as a shared precursor condition to Primary Cicatricial Alopecias (PCAs).

PIILIF(Perifollicular Infundibulo-Isthmic Lymphocytoplasmic Infiltrates and Fibrosis) Symptoms

  •         Hair loss (Alopecia)
  •         Itching, redness, and inflammation of the scalp
  •         Thickened skin on affected areas
  •         Thinning of unaffected hair

In addition, other symptoms may include early stages of Primary Cicatricial Alopecias (PCAs).

A patient with PIILIF during a biopsy examination by Dr. Umar.
A patient with PIILIF during a biopsy examination by Dr. Umar.

How Do You Diagnose PIILIF?

A clinical diagnosis is recommended for PIILIF, as the symptoms may overlap with those of other underlying conditions.

PIILIF diagnosis methods include:

  • Physical examination. A specialist will monitor visible symptoms on the scalp and other hairy body parts, such as the beard, eyebrows, and eyelashes.
  • Trichoscopy. This method evaluates skin lesions on the affected areas under a magnifying lens and lighting to confirm the presence of PIILIF.
  • Biopsy: A sample of hair or scalp skin is observed under a microscope to ascertain the PIILIF condition before prescribing further treatment.

How to Treat PIILIF(Perifollicular Infundibulo-Isthmic Lymphocytoplasmic Infiltrates and Fibrosis)

Although PILLIF cannot be cured, health practitioners have devised several treatment options to manage the condition and prevent its progression so far.

Another key point to note is that treating Perifollicular Infundibulo-Isthmic Lymphocytoplasmic Infiltrates and Fibrosis (PIILIF) requires addressing other possible underlying conditions to counter the diseases in their early stages.

Treatment options include:

  • Oral Medications such as corticosteroids to reduce inflammation, immunosuppressants to control immunity imbalances, and antibiotics to prevent bacterial infections can be used to manage PIILIF.
  • Topical Treatments. Apply Gels, moose, and ointments to reduce inflammation and repair damaged hair follicles. 
  • Therapy. For severe cases of PIILIF, laser therapy should be employed to reduce fibrosis and improve skin texture in scarred areas.
  • Surgery. In severe PIILIF cases, grafting and excision can reduce scarring, skin lesions, and folding caused by the condition or other underlying diseases.

PIILIF(Perifollicular Infundibulo-Isthmic Lymphocytoplasmic Infiltrates and Fibrosis) Frequently Asked Questions (FAQ)

Can PIILIF be cured?

There is no cure; however, an early diagnosis can prevent progression, and various treatment methods can manage the symptoms. 

Should I see a specialist for PIILIF?

Yes. Consult a certified board dermatologist for a proper diagnosis, as it might be a precursor for other diseases.

Finally, you can get a free consultation with Dr. Sanusi Umar through this link: https://dru.com/hair-free-consultation/ or by using the consultation button below. 

References  

Doche, Isabella, et al. “Acne Keloidalis Nuchae and Folliculitis Decalvans: Same Process Affecting the Follicle or Coexisting Diseases? A Retrospective Study.” International Journal of Dermatology, vol. 58, no. 10, 26 June 2019, https://doi.org/10.1111/ijd.14565. Accessed 20 Mar. 2022.

Umar, Sanusi, et al. A Retrospective Cohort Study and Clinical Classification System of Acne Keloidalis Nuchae. Vol. 14, no. 4, 1 Apr. 2021. Accessed 17 June 2024.

Umar, Sanusi, et al. “Unveiling a Shared Precursor Condition for Acne Keloidalis Nuchae and Primary Cicatricial Alopecias.” Clinical, Cosmetic and Investigational Dermatology, vol. Volume 16, 1 Aug. 2023, pp. 2315–2327, https://doi.org/10.2147/ccid.s422310. Accessed 17 June 2024.

Wang, Eddy H C, et al. “Primary Cicatricial Alopecias Are Characterized by Dysregulation of Shared Gene Expression Pathways.” PNAS Nexus, vol. 1, no. 3, 11 July 2022, https://doi.org/10.1093/pnasnexus/pgac111.