Lichen Planopilaris in Women: A Retrospective Review at Mayo Clinic (1992-2016)

In a retrospective review at Mayo Clinic from 1992 to 2016, 232 women with lichen planopilaris (LPP) were studied to understand clinicopathologic findings, comorbidities, and treatment outcomes. The average age of the patients was 59.8 years, with 92.7% presenting with hair loss and 23.7% having preceding inflammation. A significant number of patients had thyroid disease (30.6%), with hypothyroidism being the most common (23.2%), and vitamin D deficiency was observed in 9.4%. High incidences of depression (45.7%) and anxiety (41.8%) were noted, as well as a history of total abdominal hysterectomy/bilateral salpingo-oophorectomies (16.8%) and hormone replacement therapy (16.4%). Lichen planus at other body sites was present in 16.4% of patients. Treatment led to slowing of disease progression or stabilization in 53.2% of patients, with a mean time to recurrence of 1.8 years and to remission of 1.1 years. The study highlighted that LPP is commonly associated with thyroid disease, and patients often have higher rates of depression, anxiety, nutritional deficiencies, and skin cancer compared to the general population.