Lichen planopilaris

Recent studies on molecular pathways have elucidated novel therapeutic approaches in inflammatory and autoimmune skin disorders. Specifically, the dysregulation of the Janus kinase signal transducer and activator of transcription (JAK-STAT) cascade plays a central role in the pathogenesis of many skin conditions. JAK inhibitors, with their ability to selectively target immune responses, are potential treatment options. Using the National Library of Medicine, we provide a comprehensive review of the use of United States Food and Drug Administration (FDA)-approved and emerging JAK or tyrosine kinase 2 (TYK2) inhibitors in a wide range of dermatologic conditions, including psoriasis, vitiligo, systemic lupus erythematosus, hidradenitis suppurativa, dermatomyositis, lichen planus, lichen planopilaris, sarcoidosis and graft-versus-host disease...

Lichen planus (LP) is a common inflammatory skin disorder with multiple variants. The coexistence of lichen planus pigmentosus (LPPigm) and frontal fibrosing alopecia is well-established in the literature. However, the coexistence of LPPigm and classic lichen planopilaris (LPP) is rare. We report a case of LPPigm and classic LPP in a postmenopausal woman with a literature review.

INTRODUCTION: The diseases causing chronic diffuse alopecia and having similar clinical findings, namely chronic telogen effluvium, androgenetic alopecia, and the alopecia with overlapping features, should be differentiated. Recently, diffuse variants of lichen planopilaris have been described with histopathologic features of lichen planopilaris but clinically presenting with diffuse hair loss mostly in an androgenetic pattern. OBJECTIVES: To determine the accurate diagnosis underlying chronic diffuse alopecia in women by evaluating histopathologic findings...

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BACKGROUND: Alopecia may decrease patients' quality of life and self-confidence by limiting their social life. Therefore, the main goal of the treatment is to limit or halt the progression of inflammation, scarring, and hair loss. The promising effect of fat injection on hair regrowth, limited adverse effects, and subsiding inflammation can be proof of its efficacy and safety in treating alopecia. AIMS: This review sought to assess the role of autologous fat tissue injection in scarring and non-scarring alopecia...

Red scalp is a common complaint which may constitute a diagnostic and therapeutic challenge in daily clinical practice. Among the numerous diseases which cause diffuse scalp erythema are psoriasis, seborrheic dermatitis, contact dermatitis, diffuse lichen planopilaris, dermatomyositis and scalp rosacea. Accurate diagnosis is crucial for optimal treatment outcomes. Histology most frequently discriminates the underlying condition, but it requires scalp biopsy. In many cases the combination of clinical examination and trichoscopy is sufficient for establishing the correct diagnosis...

OBJECTIVE: This review examines the current literature on the gut-skin connection in alopecia and summarizes interventions that impact hair growth by modulation of the gut or skin microbiome. METHODS: PubMed searches were done to assess studies of the gut and skin microbiome and forms of alopecia including, alopecia areata (AA), androgenic alopecia (AGA), alopecia universalis (AU), central centrifugal cicatricial alopecia (CCCA) and lichen planopilaris (LPP). Filters were applied for human and animal studies...

KEY CLINICAL MESSAGE: Ulcerative lichen planus, a challenging variant of lichen planus, has limited response to traditional treatments. Tofacitinib, a JAK-STAT pathway inhibitor, shows promise in effectively treating these lesions. ABSTRACT: Lichen planus is a mucocutaneous disease that can cause various manifestations, such as itchy erythematous papules, cicatricial alopecia, erosion, and mucocutaneous ulcers. One uncommon manifestation of this disease is the occurrence of erosion and skin ulcers in the soles of the feet, which can cause many problems for patients...

BACKGROUND: Lichen planopilaris (LPP) is a primary chronic lymphocytic cutaneous disorder that selectively destroys the hair follicles, resulting in a scarring alopecia. Unfortunately, current available treatments are not fully effective to stop hair loss, and the level of evidence for medical interventions is weak. METHODS: A systematic review and meta-analysis was performed including randomized trials that report the outcomes of lichen planopilaris activity index (LPPAI)...

INTRODUCTION: Lichen planus (LP) is an inflammatory skin disorder that can present in various forms across the body, including lesions on the skin (cutaneous LP [CLP]), scalp (lichen planopilaris [LPP]) and mucosal regions (mucosal LP [MLP]). Several existing patient-reported outcome measures (PROMs) were identified for potential use in LP clinical development programs. This study aimed to assess the content validity and psychometric measurement properties of the Dermatology Life Quality Index (DLQI), Epworth Sleepiness Scale (ESS), Scalpdex and Oral Lichen Planus Symptom Severity Measure (OLPSSM) in an LP population...

Lichen planus (LP) presents with a range of clinical subtypes. It can affect the outer skin, involve the nails and present with alopecia and mucosal symptoms to varying degrees. While LP of the outer skin mostly shows a self-limiting course, this does not apply for Lichen planopilaris and the mucosa affecting subtypes. The pathogenesis of LP is still incompletely understood. Thus, an effective, targeted therapy is currently lacking and different immunomodulatory approaches are being used in clinical practice...

BACKGROUND: Fibrosing alopecia in a pattern distribution (FAPD) is a distinct entity of primary cicatricial alopecia (PCA), mimicking diffuse hair loss of androgenetic alopecia (AGA) with trichoscopic and histopathologic features of both AGA and lichen planopilaris (LPP). METHODS: Clinical, demographic, and histopathological data of 20 FAPD patients were retrospectively collected. RESULTS: All patients presented with female pattern hair loss with a median Sinclair grade of 3...

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PURPOSE: Folliculitis decalvans (FD) is a difficult-to-treat, localized scarring alopecia characterized by an expanding area of chronically inflamed purulent plaques or masses. Current treatment modalities vary and often result in only temporary remission. There are no reports of surgical therapies for FD. Here, we describe FD treatment using surgical excision and second-intention healing aided by guarded high-tension sutures. METHODS: Five patients (one woman and four men) with histologically confirmed FD were treated by surgical lesion excision...

PURPOSE: Small observational studies suggest subclinical disease occurrence in the normal-appearing scalp zones of several primary cicatricial alopecias. To aid patient management, we began routinely evaluating the entire scalp of patients with acne keloidalis nuchae (AKN), including trichoscopy-guided biopsies. PATIENTS AND METHODS: This retrospective study evaluated 41 patients sequentially presenting with AKN at a single clinic between June and December 2022...

Cyclosporine A constitutes an immunosuppressive medication administered against various autoimmune and autoinflammatory disorders as well as against graft versus host disease. Its most well-known oral adverse effect is gingival hyperplasia. The aim of this study is to report a persistent case of a patient with lichen planopilaris with alopecia treated with cyclosporine leading to the manifestation of gingival hypertrophy. A female patient aged 38 years old was referred to the Department of Oral Medicine/Pathology, Dental School, Aristotle University of Thessaloniki, Greece complaining about gum bleeding, halitosis, and a persistent gingival enlargement, which appeared two months ago...

Trichoscopy is currently regarded as an essential part of the hair loss consultation. It allows visualization of morphologic structures that are not obvious to the naked eye, including peri- and interfollicular skin surface abnormalities and changes to hair shaft thickness and shape. In this paper, we aim to discuss current knowledge on trichoscopy of the most common forms of scarring and nonscarring alopecias.

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