Comparison of Systemic Mycophenolate Mofetil with Topical Clobetasol in Lichen Planopilaris: A Parallel-Group, Assessor- and Analyst-Blinded, Randomized Controlled Trial

    Vahideh Lajevardi, Saeed Ghodsi, Azadeh Goodarzi, Pardis Hejazi, Arghavan Azizpour, Sara Beygi
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    TLDR Topical clobetasol is recommended over mycophenolate mofetil for treating Lichen Planopilaris due to better safety and patient satisfaction.
    In a randomized controlled trial with 60 patients, systemic mycophenolate mofetil (MMF) and topical clobetasol were equally effective in reducing the Lichen Planopilaris Activity Index (LPPAI) over 6 months, with no serious irreversible adverse effects. Patient satisfaction with MMF increased over time, while it declined for clobetasol. Despite similar efficacy, topical clobetasol was recommended as a more suitable first-line treatment due to its safety profile and patient satisfaction, with MMF as an alternative for those not responding to other treatments or with additional systemic features of lichen planus. Further placebo-controlled trials with larger sample sizes were suggested.
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