Baibergenova Akerke, Donovan Jeff
Division of Dermatology, University of Toronto Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
Skinmed. 2013 May-Jun;11(3):161-5.
Lichen planopilaris (LPP) is considered to be a follicular variant of lichen planus. Clinical variants include classic LPP, frontal fibrosing alopecia, and the Graham-Little-Piccardi-Lassueur syndrome. The pathogenesis of LPP remains to be fully elucidated, but like other cicatricial alopecias involves the irreversible destruction of hair follicle stem cells and loss of a hair follicle's capacity to regenerate itself In the early stages of LPP, patients may have scalp pruritus, burning, tenderness, and increased hair shedding. A scalp biopsy shows a lymphocytic infiltrate involving the isthmus and infundibulum. Apoptotic cells present in the external root sheath and concentric fibrosis surrounds the hair follicle. Treatment is prescribed with the goal to alleviate patient symptoms and to halt the progression of hair loss. Treatment involves use of potent topical corticosteroids and/or intralesional corticosteroids. Options for systemic treatment include anti-inflammatory agents such as hydroxychloroquine, tetracyclines, pioglitazones, and immunosuppressive medications such as cyclosporine, mycophenolate mofetil, or systemic corticosteroids. Hair transplantation may also be an option if the disease has been in clinical remission. The management of LPP can sometimes be challenging and additional research is needed to improve outcomes for patients.
扁平苔藓性毛囊病（LPP）被认为是扁平苔藓的一种毛囊变异型。临床变异型包括经典LPP、额部纤维性脱发以及格雷厄姆 - 利特尔 - 皮卡迪 - 拉萨厄尔综合征。LPP的发病机制仍有待充分阐明，但与其他瘢痕性脱发一样，涉及毛囊干细胞的不可逆破坏以及毛囊自我再生能力的丧失。在LPP的早期阶段，患者可能会出现头皮瘙痒、灼痛、压痛以及脱发增多。头皮活检显示淋巴细胞浸润累及峡部和漏斗部。外根鞘中存在凋亡细胞，毛囊周围有同心性纤维化。治疗的目的是缓解患者症状并阻止脱发进展。治疗方法包括使用强效外用糖皮质激素和/或皮损内注射糖皮质激素。全身治疗的选择包括抗炎药物，如羟氯喹、四环素、吡格列酮，以及免疫抑制药物，如环孢素、霉酚酸酯或全身用糖皮质激素。如果疾病处于临床缓解期，毛发移植也可能是一种选择。LPP的管理有时具有挑战性，需要更多研究来改善患者的治疗效果。
