Lichen Planopilaris and Frontal Fibrosing Alopecia: Review and Update of Diagnostic and Therapeutic Features

    April 2022 in “ Anais brasileiros de dermatologia/Anais Brasileiros de Dermatologia ”
    Carolina Oliveira Costa Fechine, Neusa Yuriko Sakai Valente, Ricardo Romiti
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    TLDR The document concludes that more research is needed to find effective treatments for Lichen planopilaris and Frontal fibrosing alopecia.
    The document reviews the diagnostic and therapeutic features of Lichen planopilaris (LPP) and Frontal fibrosing alopecia (FFA), two types of scarring alopecia. Diagnosis is typically confirmed through a scalp biopsy, with FFA considered a variant of LPP due to similar histopathological findings. There are no validated treatments or guidelines, with recommendations varying based on individual patient characteristics. Various treatments are discussed, including systemic retinoids, which showed disease stabilization in 79% and 73% of patients respectively, compared to 43% in the finasteride group. Other treatments include PPAR-gamma agonists, naltrexone, diode laser devices, and hair transplant surgery. However, the lack of randomized clinical trials prevents definitive conclusions about the most effective treatments. The document emphasizes the need for more research to establish effective treatments for both conditions.
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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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