Hair Loss Due to Lichen Planopilaris After Hair Transplant: Case Reports and Literature Review

    Márcio Crisóstomo, Manoela C. C. Crisóstomo, Marília Gabriela Rocha Crisóstomo, Victor José Timbó Gondim, Mara Rocha Crisóstomo, André Nunes Benevides
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    TLDR Hair transplants can lead to hair loss from lichen planopilaris, and patients should be tested and wait two years before the procedure.
    The document describes two cases where patients experienced hair loss due to lichen planopilaris (LPP) after undergoing hair transplants, highlighting the rarity of such occurrences. The first patient had hair loss in the recipient and donor areas six years post-transplant, while the second patient showed partial hair loss with active disease two years after the procedure. Histopathological examination confirmed LPP, and one patient was treated with intralesional triamcinolone, which stabilized the lesions. The study underscores the necessity of a scalp biopsy to confirm LPP inactivity before transplantation and recommends a waiting period of at least two years of disease inactivity before proceeding with a transplant. It also advises informing patients about the potential for reduced graft integration due to the systemic and autoimmune nature of LPP.
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      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.

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