Efficacy of Oral Retinoids in Treatment-Resistant Lichen Planopilaris

    Frank C. Spano, Jeff Donovan
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    TLDR Oral retinoids may help some patients with hard-to-treat lichen planopilaris, but more research is needed.
    In a retrospective study at the University of Toronto Hair Clinic, 21 patients with treatment-resistant lichen planopilaris (LPP) were treated with oral retinoids (acitretin or isotretinoin) after not responding to first-line treatments. The study, which spanned from 2009 to 2013, found that 24% (5 of 21) of the patients showed clinical improvement within 2 to 4 months, although the most common side effect was dryness of the skin and mucosae, affecting 43% of the patients. Only 3 of the 5 responders continued the treatment after 13 to 18 months. The study concluded that oral retinoids could be a helpful adjunctive treatment for a small subset of patients with LPP, but the results were limited by the retrospective design and the small number of participants, suggesting the need for more research.
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