Lyakhovitsky A, Amichai B, Sizopoulou C, Barzilai A
Department of Dermatology, Sheba Medical Center , Tel Hashomer , Israel .
J Dermatolog Treat. 2015 Jun;26(3):275-9. doi: 10.3109/09546634.2014.933165. Epub 2014 Jul 1.
Lichen planopilaris (LPP) is as a lymphocytic variant of primary cicatricial alopecia.
To evaluate the demographics, clinical findings, natural history, and response to various treatments of LPP.
A retrospective review of medical records of all patients with clinical and histopathological diagnoses of LPP.
Out of 46 patients, there were 38 (82.6%) women and 8 (17.4%) men. There was no clear association of specific medical background and medications with disease onset. The most frequent complaint was itching scalp. Asymptomatic hair loss was observed in 39.2%. LPP involved the entire scalp in 39.1%, vertex in 28.3%, anterior scalp and vertex in 17.4%, fronto-temporal scalp in 6.5%, and posterior and parietal scalp in 6.5%. The topical treatment that caused the highest rate of symptomatic improvement was intralesional injection of corticosteroids. The treatment that led to the highest rate of remission was hydroxychloroquine combined with topical corticosteroid application. The remission rate was 6.5% after 3 months and 33% after 18 months. Of patients who achieved remission, 50% need continuous treatment to maintain remission. No patient had any visible hair regrowth on any treatment.
The range of empiric topical and systemic treatments used gives unsatisfactory results, in LPP patients.
扁平苔藓样毛发角化病（LPP）是原发性瘢痕性脱发的淋巴细胞变异型。
评估LPP的人口统计学特征、临床发现、自然病程以及对各种治疗的反应。
对所有临床和组织病理学诊断为LPP的患者的病历进行回顾性研究。
46例患者中，女性38例（82.6%），男性8例（17.4%）。疾病发作与特定的医学背景和药物之间没有明确关联。最常见的主诉是头皮瘙痒。39.2%的患者观察到无症状性脱发。LPP累及整个头皮的占39.1%，累及头顶的占28.3%，累及前头皮和头顶的占17.4%，累及额颞部头皮的占6.5%，累及后头皮和顶叶头皮的占6.5%。导致症状改善率最高的局部治疗是皮损内注射皮质类固醇。导致缓解率最高的治疗是羟氯喹联合局部应用皮质类固醇。3个月后的缓解率为6.5%，18个月后的缓解率为33%。在实现缓解的患者中，50%需要持续治疗以维持缓解。在任何治疗下，没有患者出现任何可见的毛发再生。
在LPP患者中，经验性使用的局部和全身治疗方法效果均不理想。
