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

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.