DermNet provides Google Translate, a free machine translation service. Note that this may not provide an exact translation in all languages. Lichen planopilaris is a rare inflammatory condition that results in patchy progressive permanent hair loss mainly on the scalp. Three forms are recognised:. Lichen planopilaris usually affects young adult women, although the age range is wide and it also affects men.
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DermNet provides Google Translate, a free machine translation service. Note that this may not provide an exact translation in all languages. Lichen planopilaris is a rare inflammatory condition that results in patchy progressive permanent hair loss mainly on the scalp.
Three forms are recognised:. Lichen planopilaris usually affects young adult women, although the age range is wide and it also affects men. It commonly develops in association with lichen planus affecting the skin, mucosa and nails. Although lichen planopilaris is rare, it is one of the common causes of scarring hair loss of the scalp.
Lichen planopilaris typically presents as smooth white patches of scalp hair loss. No hair follicle openings can be seen in the areas of hair loss. At the edges of these patches, there may be scale and redness around each hair follicle. Hairs can be easily pulled out. It is multifocal and small areas may merge to form larger irregular areas.
Lichen planopilaris Lichen planopilaris. Lichen planopilaris is suspected on the clinical presentation and careful examination of the mouth, nails and skin for evidence of lichen planus elsewhere.
Trichoscopy reveals absent follicles , white dots, tubular perifollicular scale and perifollicular erythema. The diagnosis may be confirmed on a scalp biopsy that includes hairs with surrounding redness and scale at the edge of an area of hair loss.
Lichen planopilaris is an example of a primary lymphocytic folliculitis. However, it is not always possible to make a diagnosis on biopsy. Biopsy from an already scarred area of hair loss is unhelpful. Where there is only patchy scarring hair loss and no evidence of inflammation the diagnosis may not be able to be confirmed. Treatment should be sought and provided early as no treatment recovers hairs that have been lost and replaced by scarring.
The aim of treatment is to slow the progression of the disease and relieve symptoms. Hair loss may continue, although at a slower rate. Response to treatment is variable and some published studies contradict others as to the efficacy. The best patients can expect is to stop the progression of hair loss and to minimise scalp discomfort. Since , there have been several reports of the use of the antidiabetic agent pioglitazone off-label for the treatment of lichen planopilaris.
Side effects include ankle swelling and weight gain. Camouflage with careful hair styling and hair colouring. Hairpieces may be required for areas of permanent hair loss. Surgery such as scalp reduction and hair transplantation has been used for end-stage disease with large areas of scarring but is not always successful. See smartphone apps to check your skin. DermNet NZ does not provide an online consultation service.
If you have any concerns with your skin or its treatment, see a dermatologist for advice. A case-series of 29 patients with lichen planopilaris: The Cleveland Clinic Foundation experience on evaluation, diagnosis, and treatment. J Am Acad Dermatol ; Efficacy and safety of mycophenolate mofetil for lichen planopilaris. Mirmirani P, Karnik P. Arch Dermatol ; — Short course of oral cyclosporine in lichen planopilaris. Commentary: Treatment of lichen planopilaris. Some progress, but a long way to go.
A histologic review of 27 patients with lichen planopilaris. Mesinkovska, Natasha Atanaskova et al. The use of oral pioglitazone in the treatment of lichen planopilaris. J Am Acad Dermatol ; — Spring, Philipp et al. Treatment of lichen planopilaris with adalimumab in a patient with hidradenitis suppurativa and rheumatoid arthritis.
Therapeutic management of classic lichen planopilaris: a systematic review
Several treatment strategies have been proposed in classic lichen planopilaris LPP , although no gold standard therapeutic approach has been recognized so far due to the variable and, sometimes, contradictory results reported in the literature, as well as due to the lack of guidelines and randomized controlled trials. In the present review, we sought to provide an updated overview on the treatment of classic LPP by analyzing the level of evidence of published studies, also proposing a possible therapeutic strategy according to the findings highlighted in this systematic review. Lichen planopilaris LPP is a relatively uncommon cutaneous disorder characterized by a chronic lymphocytic inflammation that leads to the selective destruction of hair follicles, thus resulting in scarring alopecia. LPP is more common in women than in men ratio varying from 1.
Only comments seeking to improve the quality and accuracy of information on the Orphanet website are accepted. For all other comments, please send your remarks via contact us. Only comments written in English can be processed. A rare cutaneous variant of lichen planus which affects hair follicles. The disease manifests in adulthood years of age , with some rare cases in childhood.