Patch Testing and Contact Allergen Avoidance in Patients with Lichen Planopilaris and/or Frontal Fibrosing Alopecia: A Cohort Study

    January 2020 in “ Journal of the American Academy of Dermatology ”
    Sonya Prasad, Dustin H. Marks, Laura Burns, Brianna De Souza, Elizabeth A. Flynn, Pamela L. Scheinman, Dianne L. Silvestri, JiaDe Yu, Kristen LoSicco, Maryanne M. Senna
    TLDR Avoiding certain allergens in personal care products may improve symptoms for some patients with lichen planopilaris or frontal fibrosing alopecia.
    This cohort study investigated the role of contact allergens in patients with lichen planopilaris (LPP) and/or frontal fibrosing alopecia (FFA) by conducting patch tests on 42 patients. The study found that 76.2% of patients had clinically relevant allergens in their personal care products, with common allergens including gallates, linalool, and fragrance mixes. After at least 3 months of avoiding these allergens, 70% of patients experienced decreased scalp erythema, and no patients showed worsening symptoms. The study suggested that allergen avoidance might reduce local inflammation and improve symptoms in some patients, although the direct contribution of allergic contact dermatitis to LPP and FFA pathogenesis remained unclear. The study was limited by its small sample size and nonvalidated survey but highlighted the potential benefit of routine patch testing for this patient population.
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