Recalcitrant Lichen Planopilaris and Frontal Fibrosing Alopecia Responding to Tildrakizumab

May 2020 in “ Dermatologic therapy ”

Lara Trindade de Carvalho, Nekma Meah, Dmitri Wall, Rodney Sinclair

lichen planopilaris frontal fibrosing alopecia tildrakizumab interleukin-23 monoclonal antibody cicatricial alopecia

TLDR Tildrakizumab significantly improved recalcitrant lichen planopilaris and frontal fibrosing alopecia.

The paper reported a case of recalcitrant lichen planopilaris (LPP) and frontal fibrosing alopecia (FFA) that showed significant clinical improvement after four doses of tildrakizumab, an interleukin-23 monoclonal antibody. LPP and FFA are types of lymphocytic, cicatricial alopecias, with LPP presenting as multifocal patchy alopecia and FFA causing hairline recession. The treatment aimed to arrest the inflammatory process, which is often challenging and yields variable responses.

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Research cited in this study

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research Genome-Wide Association Study in Frontal Fibrosing Alopecia Identifies Four Susceptibility Loci Including HLA-B*07:02

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research Treatment of Frontal Fibrosing Alopecia and Lichen Planopilaris: A Systematic Review

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No effective treatment for frontal fibrosing alopecia was found, but oral 5-alpha-reductase inhibitors had the best response; for lichen planopilaris, topical corticosteroids were commonly used but had a high relapse rate.

research Frontal Fibrosing Alopecia: Clinical Presentations and Prognosis

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FFA is more common in postmenopausal women, can affect younger women, and may stabilize over time.

research Frontal Fibrosing Alopecia in Postmenopausal Women

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Some postmenopausal women with frontal fibrosing alopecia stopped losing hair with finasteride treatment, hinting at a possible hormonal cause.

research Postmenopausal Frontal Fibrosing Alopecia: A Frontal Variant of Lichen Planopilaris

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Frontal fibrosing alopecia is a hair loss condition in postmenopausal women, similar to lichen planopilaris, with ineffective treatments.

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