Department of Dermatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of Medicine, Iran University of Medical Sciences (IUMS), Rasool Akram Hospital, Tehran, Iran.
Heart Valve Disease Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
J Cosmet Dermatol. 2024 Aug;23(8):2547-2555. doi: 10.1111/jocd.16302. Epub 2024 Mar 25.
Lichen planopilaris (LPP) is one of the most common causes of scarring hair loss caused by immune-mediated inflammation resulting in atrophy and scaling. The key to preventing this irreversible hair loss is diagnosing and starting treatment at the earliest possible stage. As there is no definite cure for LPP, the therapy could be challenging. In the study, we conducted a single-blinded randomized clinical trial to evaluate the therapeutic effects, safety, and tolerability of platelet-rich plasma versus topical clobetasol in the treatment of LPP.
A randomized single-blinded controlled clinical trial was conducted in 24 LPP patients referring to our dermatology clinic between August 2022 and March 2023. Patients in the control group were treated with topical clobetasol 0.05% applied at night, and patients in the case group, in addition to topical clobetasol, received three sessions of PRP injection monthly. Both groups were assessed 1, 2, and 6 months after the start of the study by the Lichen Planopilaris Activity Index (LPPAI), physician and patient satisfaction, tolerability, and recording adverse effects.
The average age in the clobetasol and PRP groups was 43.75 ± 13.51 and 42.75 ± 9.67, respectively (p = 0.83). In terms of gender, all 12 cases (100%) in the clobetasol group and 9 cases (75%) in the PRP group were female (p = 0.21). Both PRP and topical clobetasol effectively reduced LPPAI in the first 2 months; however, after 6 months, the LPPAI significantly increased in the clobetasol group (p = 0.001). There were no significant differences in LPPAI between the two groups at the beginning of the study and after 1 month. However, the mean LPPAI score in the clobetasol group was significantly higher than in the PRP group at 2 and 6 months after the start of the study (p = 0.01). Patient satisfaction with treatment increased in both groups during follow-up sessions, but at the end of the follow-up period, it was significantly higher in the PRP group (p = 0.03). Finally, the study did not have any serious adverse effects, and the pain experienced during PRP injection was tolerable for the patients. Overall, treatment tolerability was excellent in both groups.
Given the different efficacy profiles, PRP could be considered a new and effective choice for the treatment of LPP.
瘢痕性类脂性脱发（LPP）是由免疫介导的炎症导致的最常见的瘢痕性脱发原因之一，导致萎缩和鳞片。防止这种不可逆性脱发的关键是尽早诊断和开始治疗。由于 LPP 没有明确的治疗方法，因此治疗可能具有挑战性。在研究中，我们进行了一项单盲随机临床试验，以评估富血小板血浆与局部卤倍他索在治疗 LPP 中的治疗效果、安全性和耐受性。
2022 年 8 月至 2023 年 3 月期间，我们在皮肤科诊所对 24 例 LPP 患者进行了一项随机单盲对照临床试验。对照组患者每晚接受局部卤倍他索 0.05%治疗，而病例组患者除了局部卤倍他索外，每月还接受三次 PRP 注射。两组患者在研究开始后 1、2 和 6 个月分别通过 Lichen Planopilaris Activity Index（LPPAI）、医生和患者满意度、耐受性和记录不良反应进行评估。
卤倍他索组和 PRP 组的平均年龄分别为 43.75±13.51 和 42.75±9.67（p=0.83）。就性别而言，卤倍他索组 12 例（100%）和 PRP 组 9 例（75%）均为女性（p=0.21）。PRP 和局部卤倍他索均可在头 2 个月有效降低 LPPAI；然而，6 个月后，卤倍他索组的 LPPAI 显著增加（p=0.001）。在研究开始时和 1 个月时，两组之间的 LPPAI 没有显著差异。然而，在研究开始后的 2 个月和 6 个月，卤倍他索组的平均 LPPAI 评分明显高于 PRP 组（p=0.01）。两组患者的治疗满意度均在随访期间有所提高，但在随访结束时，PRP 组明显更高（p=0.03）。最后，该研究没有任何严重的不良反应，PRP 注射时的疼痛可被患者耐受。总体而言，两组的治疗耐受性均极佳。
鉴于不同的疗效特征，PRP 可被视为治疗 LPP 的一种新的有效选择。
