Overview of Lichen Planopilaris: Diagnosis and Treatment

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.