Overview of Lichen Planopilaris: Diagnosis and Treatment
January 2019
in “
Elsevier eBooks
”
Lichen Planopilaris scarring alopecia autoimmune etiology HLA alleles hypothyroidism polycystic ovarian syndrome sebaceous gland dysfunction PPAR-y protein dermoscopy histopathology perifollicular erythema topical corticosteroids calcineurin inhibitors tetracycline antibiotics doxycycline minocycline hydroxychloroquine thiazolidinediones oral retinoids mycophenolate mofetil cyclosporine A oral prednisone LPP autoimmune HLA PCOS PPAR-gamma topical steroids tetracyclines Plaquenil mycophenolate cyclosporine prednisone
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.
