Mycophenolate Mofetil in the Management of Lichen Planus Pigmentosus in a Woman with Frontal Fibrosing Alopecia

    Su Su Htwe, Susan Holmes
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    Studysummary In this case study, a woman with frontal fibrosing alopecia and associated hyperpigmentation showed significant improvement in skin pigmentation and itch after 9 months of treatment with mycophenolate mofetil, highlighting its therapeutic potential for lichen planus pigmentosus linked to this condition. Our plain-language summary of this paper — not a Tressless recommendation.
    A 50-year-old South Asian woman with frontal fibrosing alopecia (FFA) and lichen planus (LP) pigmentosus experienced worsening pigmentation and itching despite initial treatments. After 12 months on hydroxychloroquine and 6 months on low-dose isotretinoin, her condition did not improve. However, a trial of mycophenolate mofetil 500 mg twice daily led to significant improvement in skin pigmentation and itching after 9 months, while her hairline recession remained stable. This case underscores the potential therapeutic benefit of mycophenolate mofetil in managing LP pigmentosus associated with FFA, particularly in patients with darker skin types.
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