Please login or create an account. If you do not have access to this content, you will be shown a 30 second preview and licensing options.
- Presentation
Lichen Planopilaris: What I Do
Description
In this presentation on lichen planopilaris (LPP), the speaker emphasizes their exclusive focus on scalp and hair disorders, detailing their patient demographics and the clinical characteristics of LPP as a type of scarring alopecia. They outline the importance of a thorough patient history and scalp examination, and highlight the absence of robust evidence-based studies for effective treatments. The speaker discusses their treatment strategies based on LPP severity, noting the use of oral prednisone for rapidly progressive cases, monthly cortisone injections for limited involvement, and a mixture of topical treatments including tacrolimus, clobetasol, and minoxidil. Additional systemic options such as doxycycline, hydroxychloroquine, and newer therapies like pioglitazone and low-dose naltrexone are explored, along with the beneficial role of excimer laser therapy. The speaker emphasizes the need for a personalized approach in managing LPP, considering factors like symptomatology and patient response to treatment. They conclude by acknowledging their research team and opening the floor for any questions.
View moreConclusions
- Lichen planopilaris occurs predominantly in adults and is characterized by itching, burning, and variable hair shedding.
- Clinical evaluation of lichen planopilaris includes a thorough history, scalp observation, and specific examination tests such as hair pull and card tests.
- Treatment for lichen planopilaris relies on clinical activity indicators like erythema, hyperkeratosis, pain, and positive pull tests.
- There is no substantial evidence supporting the efficacy of existing treatments for lichen planopilaris, as no randomized controlled trials have been published.
- Oral prednisone is used to treat rapidly progressive lichen planopilaris, tapering off after 8 weeks.
- Intralesional corticosteroid injections are effective for cases with less than 10% scalp involvement, while systemic treatments are necessary for broader involvement.
- Adjunctive therapies like low-dose naltrexone and pioglitazone show promise in reducing symptoms and improving hair follicle function.
- Laser treatment using 308 nm excimer laser may help reduce inflammation and scalp symptoms in lichen planopilaris.
- Platelet-rich plasma may have a role in managing lichen planopilaris, though further research is necessary to establish its efficacy.
- DERMATOLOGIC THERAPY. Volume 21, Number 4, July/August 2008. Evaluation and Treatment of Scarring Alopecias. Guest Editor Jerry Shapiro. Editor-in-Chief Michael D. Tharp.
- Journal of American Academy of Dermatology. Update on primary cicatricial alopecias. July 2005.
- Svigos K, Yin L, Fried L, Lo Sicco K, Shapiro J. A Practical Approach to the Diagnosis and Management of Classic Lichen Planopilaris. Am J Clin Dermatol. 2021;22(5):681-692. doi:10.1007/s40257-021-00630-7.
- Lauren C. Strazzulla BA, Lorena Avila MD, Kristen Lo Sicco MD, Jerry Shapiro MD. Novel Treatment Using Low-Dose Naltrexone for Lichen Planopilaris. Journal of Drugs in Dermatology. VOLUME 16 · ISSUE 11, November 2017, 1140.
- Erik L. Peterson BS, Daniel Gutierrez MD, Nooshin K. Brinster MD, Kristen I. Lo Sicco MD, Jerry Shapiro MD. Response of Lichen Planopilaris to Pioglitazone Hydrochloride. CASE REPORT. DECEMBER 2019, JOURNAL OF DRUGS IN DERMATOLOGY.