Acquired Hyperpigmentation and Cicatricial Alopecia

    April 2016 in “ The American Journal of the Medical Sciences ”
    Jorge Ocampo‐Garza, Maira Elizabeth Herz‐Ruelas, Jorge Ocampo‐Candiani
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    TLDR The document concludes that doctors should check for frontal fibrosing alopecia in patients with acquired hyperpigmentation and that early treatment is important.
    The document discusses a case of a 69-year-old Hispanic postmenopausal woman who presented with acquired hyperpigmentation and cicatricial alopecia, specifically lichen planus pigmentosus (LPP) and frontal fibrosing alopecia (FFA). LPP is characterized by grey to brown macules, particularly in sun-exposed areas, and FFA is a scarring alopecia affecting the frontal hairline and eyebrows, mainly in postmenopausal women. The patient's skin and scalp biopsies were consistent with LPP and FFA, respectively. She was treated with chloroquine, topical tacrolimus, and sunscreen, resulting in mild improvement. The document highlights the importance of examining patients with acquired hyperpigmentation for signs of FFA to initiate early treatment and prevent further alopecia. It also notes that more than 50% of patients with FFA have LPP, and LPP usually precedes FFA by several months to years. There is no established treatment for FFA, but corticosteroids, hydroxychloroquine, and oral finasteride or dutasteride have been reported to be effective. The case emphasizes the need for awareness among physicians of the potential coexistence of LPP and FFA.
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      If You Have DUPA, PLEASE READ THIS: Everyone Should Be Scalp Biopsied

      community If You Have DUPA, PLEASE READ THIS: Everyone Should Be Scalp Biopsied

      in Research  830 upvotes 7 months ago
      Scalp biopsies are crucial for diagnosing hair loss conditions like Diffuse Unpatterned Alopecia (DUPA) and retrograde hair loss, as treatments like finasteride and dutasteride may not be effective if other conditions are present. Combining PPAR-GAMMA agonists with retinoids could improve treatments for conditions like Lichen Planopilaris.

      community Losing Hair on Dutasteride? You might have LPP

      in Research/Science  96 upvotes 3 weeks ago
      Men with hair loss might have lichen planopilaris (LPP), which can mimic androgenetic alopecia, leading to misdiagnosis and ineffective treatment with finasteride or dutasteride. Proper diagnosis, including biopsies, is crucial to distinguish between androgenetic alopecia and conditions like LPP.

      community You will lose hair if your prostaglandins aren't in balance

      in Research/Science  53 upvotes 1 week ago
      Prostaglandin balance affects hair loss, particularly in conditions like Lichen Planopilaris, where an imbalance can lead to hair follicle damage. Treatments mentioned include prostaglandin analogs and Pioglitazone HCL, with a focus on maintaining prostaglandin equilibrium for potential hair regrowth.

      community scarring alopecia awareness in this community

      in Chat  33 upvotes 2 years ago
      Lichen Planopilaris (LPP), a form of permanent hair loss, which can be mistaken for seborrheic dermatitis and is characterized by scalp itching, burning, redness, and dandruff. Treatment options discussed include steroidal creams, finasteride, minoxidil, and RU58841.

      community I am a dermatologist with a clinical interest in alopecia. AMA

      in Will treatment work for me? 2 years ago
      In this conversation, 4990 discussed various treatments for hair loss, including oral minoxidil, PRP, transplan, Jak inhibitors, Dutasteride, Finasteride, Olumiant, Ketoconazole, RU58841, microneedling, baricitinib, and CCCA. They recommended scalp biopsies in unclear cases of DUPA, twice weekly to twice daily shampooing for topical minoxidil users, and two sessions spaced one month apart with follow up at month three to determine the effectiveness of PRP treatment.

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