Lichen Planopilaris

Is a chronic progressive primary lymphocyctic scarring alopecia.  It presents with red rough bumps, scales around the follicles, pimples around the follicle, patchy thinning, and or complete balding.  It may also be associated with itching, burning, pain, and hair shedding.  There are two clinical types (frontal fibrosing alopecia, and Graham-Little Syndrome). The exact cause of LPP is unknown.  However, some proposed mechanisms include autoimmune dysfunction, reduction in peroxisome proliferator-activated receptor gamma (PPAR-γ or PPARG), genetic predisposition, and more recently interferon (IFN)-γ dysfunction. It has been associated with thyroid disease, hirsutism. Possible treatment options include oral anti-inflammatory medications (i.e. Oral antimalarials (hydroxychlroquine), steroids (systemic, topical/ injection), PPAR-γ modulators (i.e. Pioglitazone), μ-opioid receptor antagonist. Emerging therapies include Janus kinase inhibitors, and platelet rich plasma.

References:

- Errichetti E, Figini M, Croatto M, Stinco G.  Therapeutic management of classic lichen planopilaris: a systematic review.  Clin Cosmet Investig Dermatol. 2018 Feb 27;11:91-102.

​-Strazzulla LC, Avila L, Lo Sicco K, Shapiro J.  Novel Treatment Using Low-Dose Naltrexone for Lichen Planopilaris.  J Drugs Dermatol. 2017 Nov 1;16(11):1140-1142.​

-Yang CC, Khanna T, Sallee B, Christiano AM, Bordone LA.  Tofacitinib for the treatment of lichen planopilaris: A case series.  Dermatol Ther. 2018 Sep 27:e12656.

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