Overview of Lichen Planopilaris: Diagnosis and Treatment

July 2018 in “ Elsevier eBooks ”

Nisha S. Desai, Paradi Mirmirani

TLDR Lichen Planopilaris is a hair loss condition best treated early with various medications, including hydroxychloroquine, to prevent permanent baldness.

The document from 2019 provides an overview of Lichen Planopilaris (LPP), a scarring alopecia with autoimmune etiology, affecting mainly Caucasian middle-aged females. It is associated with certain HLA alleles, hypothyroidism, and polycystic ovarian syndrome, with pathogenesis linked to sebaceous gland dysfunction and a defect in PPAR-y protein. Diagnosis is made through dermoscopy and histopathology, showing characteristic features like perifollicular erythema. Treatment options include topical corticosteroids, calcineurin inhibitors, and systemic therapies such as tetracycline antibiotics, with doxycycline and minocycline having a 57% response rate. Hydroxychloroquine is the gold-standard systemic treatment with a 53-83% response rate. Other treatments like thiazolidinediones, oral retinoids, and mycophenolate mofetil (with an 83% effectiveness in a 16-patient series) are considered, while cyclosporine A and oral prednisone are reserved for short-term use. Early diagnosis and potentially combined treatments are crucial for preventing permanent hair loss.

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Research cited in this study

23 / 23 results

research Prevalence of Hormonal and Endocrine Dysfunction in Patients with Lichen Planopilaris: A Retrospective Data Analysis of 168 Patients

44 citations, February 2017 in “Journal of the American Academy of Dermatology”

Lichen planopilaris (LPP) is linked to androgen excess, while frontal fibrosing alopecia (FFA) is linked to androgen deficiency.

research Primary Cicatricial Alopecia: Treatment Approaches and Classification

95 citations, November 2016 in “Journal of The American Academy of Dermatology”

Treatments for permanent hair loss from scarring aim to stop further loss, not regrow hair, and vary by condition, with partial success common.

research A New Subtype of Lichen Planopilaris Affecting Vellus Hairs and Clinically Mimicking Androgenetic Alopecia

9 citations, September 2016 in “Dermatologic Surgery”

New LPP subtype affects vellus hairs, mimics AGA, and needs biopsy for diagnosis.

research Linear Lichen Planopilaris of the Face: Case Report and Review

5 citations, January 2016 in “Skin appendage disorders”

A rare skin condition called linear lichen planopilaris caused itchy red bumps and hair loss on a man's face.

research Lichen Planopilaris Epidemiology: A Retrospective Study of 80 Cases

37 citations, October 2015 in “Anais Brasileiros de Dermatologia”

Lichen planopilaris mostly affects women with fair skin and can look different on each person, needing early treatment to prevent hair loss.

research Efficacy of Oral Retinoids in Treatment-Resistant Lichen Planopilaris

16 citations, October 2014 in “Journal of the American Academy of Dermatology”

Oral retinoids may help some patients with hard-to-treat lichen planopilaris, but more research is needed.

research A Case Series of 46 Patients With Lichen Planopilaris: Demographics, Clinical Evaluation, and Treatment Experience

47 citations, June 2014 in “Journal of Dermatological Treatment”

Most treatments for lichen planopilaris were found to be generally unsatisfactory.

Lichen Planopilaris Treated by the Peroxisome Proliferator-Activated Receptor-γ Agonist Pioglitazone: Lack of Lasting Improvement or Cure in the Majority of Patients

research Lichen Planopilaris Treated by the Peroxisome Proliferator-Activated Receptor-γ Agonist Pioglitazone: Lack of Lasting Improvement or Cure in the Majority of Patients

33 citations, October 2013 in “Journal of The American Academy of Dermatology”

Pioglitazone usually doesn't effectively treat or cure lichen planopilaris.

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

117 citations, March 2013 in “Journal of the European Academy of Dermatology and Venereology”

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 Cicatricial Alopecia Symposium 2011: Lipids, Inflammation, and Stem Cells

4 citations, May 2012 in “Journal of Investigative Dermatology”

The symposium concluded that a specific lipid might cause hair loss, inflammation is a key factor, and stem cells in bald scalps aren't working right, suggesting new treatment targets.

research Sebaceous Gland Loss and Inflammation in Scarring Alopecia: A Potential Role in Pathogenesis

37 citations, June 2011 in “Journal of The American Academy of Dermatology”

Loss of sebaceous glands and inflammation may contribute to the development of scarring alopecia.

research The HoVert Technique: A Novel Method for the Sectioning of Alopecia Biopsies

44 citations, January 2011 in “Journal of Cutaneous Pathology”

The HoVert technique is a simple, cost-effective new method that improves alopecia diagnosis by allowing detailed analysis from a single biopsy.

research Efficacy and Safety of Mycophenolate Mofetil for Lichen Planopilaris

66 citations, January 2010 in “Journal of The American Academy of Dermatology”

Mycophenolate mofetil was effective for most patients in treating scarring hair loss, but some had side effects.

research Lichen Planopilaris: Chronic Scarring Alopecia with Autoimmune Component

90 citations, July 2008 in “Dermatologic therapy”

Lichen planopilaris is a chronic, scarring hair loss condition with no definitive cure, requiring accurate diagnosis and treatment to manage symptoms.

research Onset of Lichen Planopilaris During Treatment with Etanercept

39 citations, March 2008 in “British Journal of Dermatology”

Etanercept may cause lichen planopilaris, so doctors should be cautious.

research Linear Lichen Planopilaris of the Trunk: First Report of a Case

18 citations, May 2006 in “Journal of Cutaneous Medicine and Surgery”

Linear lichen planopilaris can affect the trunk, not just the face.

research The Medical Treatment of Cicatricial Alopecia

46 citations, March 2006 in “Seminars in Cutaneous Medicine and Surgery”

Current treatments for cicatricial alopecia can manage symptoms but don't stop hair loss or the disease.

research Scd1 ab-Xyk: A New Asebic Allele Characterized by a CCC Trinucleotide Insertion in Exon 5 of the Stearoyl-CoA Desaturase 1 Gene in Mouse

12 citations, July 2004 in “Molecular genetics and genomics”

A new mouse mutation causes skin and hair defects due to a gene change.

research Primary Cicatricial Alopecias: Clinicopathology of 112 Cases

254 citations, December 2003 in “Journal of the American Academy of Dermatology”

Accurate diagnosis and aggressive treatment are crucial to prevent permanent hair loss in cicatricial alopecia.

Cyclosporin A-Induced Hair Growth in Mice Is Associated with Inhibition of Calcineurin-Dependent Activation of NFAT in Follicular Keratinocytes

research Cyclosporin A-Induced Hair Growth in Mice Is Associated with Inhibition of Calcineurin-Dependent Activation of NFAT in Follicular Keratinocytes

57 citations, June 2003 in “American Journal of Physiology-cell Physiology”

Cyclosporin A helps mice grow hair by blocking a specific protein activity in skin cells.

research Asebia-2J (Scd1ab2J): A New Allele and a Model for Scarring Alopecia

179 citations, June 2000 in “The American journal of pathology”

The absence of functional sebaceous glands causes hair follicle destruction and scarring alopecia.

research Fibrosing Alopecia in a Pattern Distribution

158 citations, February 2000 in “Archives of dermatology”

Some people with pattern hair loss may also have scalp inflammation and scarring similar to lichen planopilaris.

research Hair Follicle Biology, the Sebaceous Gland, and Scarring Alopecias

57 citations, August 1999 in “Archives of dermatology”

Hair follicles grow hair and release it through the skin.

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