Systemic Treatments for Lichen Planopilaris and Frontal Fibrosing Alopecia: A Retrospective Study of 315 Patients

Lichen planopilaris and frontal fibrosing alopecia are common variants of primary lymphocytic cicatricial alopecia, leading to permanent hair loss. Despite widespread use of various systemic treatments, evidence-based guidelines for these conditions are lacking. This study investigates the effective...

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Main Authors: Mathias Willaert, Tristan van Dongen, Petra Dikrama, Tamar Nijsten, DirkJan Hijnen, Rick Waalboer-Spuij
Format: Article
Language:English
Published: Medical Journals Sweden 2025-04-01
Series:Acta Dermato-Venereologica
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Online Access:https://medicaljournalssweden.se/actadv/article/view/42465
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author Mathias Willaert
Tristan van Dongen
Petra Dikrama
Tamar Nijsten
DirkJan Hijnen
Rick Waalboer-Spuij
author_facet Mathias Willaert
Tristan van Dongen
Petra Dikrama
Tamar Nijsten
DirkJan Hijnen
Rick Waalboer-Spuij
author_sort Mathias Willaert
collection DOAJ
description Lichen planopilaris and frontal fibrosing alopecia are common variants of primary lymphocytic cicatricial alopecia, leading to permanent hair loss. Despite widespread use of various systemic treatments, evidence-based guidelines for these conditions are lacking. This study investigates the effectiveness of systemic treatment options in patients with lichen planopilaris and frontal fibrosing alopecia through a retrospective cohort analysis. Medical records of patients treated at the Department of Dermatology between 2016 and 2022 at the Erasmus University Medical Center Rotterdam, the Netherlands were reviewed. Of 315 patients identified (161 lichen planopilaris and 154 frontal fibrosing alopecia), the majority were female (90.5%), with hydroxychloroquine being the most common systemic treatment, used by 65.2% of lichen planopilaris and 57.8% of frontal fibrosing alopecia patients. Methotrexate had the highest response rate for lichen planopilaris (79.2%), while retinoids showed the highest response for frontal fibrosing alopecia (73.9%). However, treatments with cyclosporine A and retinoids had higher discontinuation rates due to side effects. This study suggests methotrexate and cyclosporine A may be most effective for lichen planopilaris, and cyclosporine A and retinoids for frontal fibrosing alopecia, though side effects remain a concern. Limitations include the retrospective design and the absence of standardized outcomes. Prospective studies are recommended to validate these findings.
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spelling doaj-art-4be542a0476849c28ffcd06b0318ffb02025-08-20T02:19:11ZengMedical Journals SwedenActa Dermato-Venereologica0001-55551651-20572025-04-0110510.2340/actadv.v105.42465Systemic Treatments for Lichen Planopilaris and Frontal Fibrosing Alopecia: A Retrospective Study of 315 PatientsMathias Willaert0Tristan van Dongen1Petra Dikrama2Tamar Nijsten3DirkJan Hijnen4Rick Waalboer-Spuij5Department of Dermatology, Erasmus MC University Medical Center, Rotterdam, the NetherlandsDepartment of Dermatology, Spaarne Gasthuis, Haarlem, the NetherlandsDepartment of Dermatology, Erasmus MC University Medical Center, Rotterdam, the NetherlandsDepartment of Dermatology, Erasmus MC University Medical Center, Rotterdam, the NetherlandsDepartment of Dermatology, Radboud University Medical Center, Nijmegen, the NetherlandsDepartment of Dermatology, Erasmus MC University Medical Center, Rotterdam, the NetherlandsLichen planopilaris and frontal fibrosing alopecia are common variants of primary lymphocytic cicatricial alopecia, leading to permanent hair loss. Despite widespread use of various systemic treatments, evidence-based guidelines for these conditions are lacking. This study investigates the effectiveness of systemic treatment options in patients with lichen planopilaris and frontal fibrosing alopecia through a retrospective cohort analysis. Medical records of patients treated at the Department of Dermatology between 2016 and 2022 at the Erasmus University Medical Center Rotterdam, the Netherlands were reviewed. Of 315 patients identified (161 lichen planopilaris and 154 frontal fibrosing alopecia), the majority were female (90.5%), with hydroxychloroquine being the most common systemic treatment, used by 65.2% of lichen planopilaris and 57.8% of frontal fibrosing alopecia patients. Methotrexate had the highest response rate for lichen planopilaris (79.2%), while retinoids showed the highest response for frontal fibrosing alopecia (73.9%). However, treatments with cyclosporine A and retinoids had higher discontinuation rates due to side effects. This study suggests methotrexate and cyclosporine A may be most effective for lichen planopilaris, and cyclosporine A and retinoids for frontal fibrosing alopecia, though side effects remain a concern. Limitations include the retrospective design and the absence of standardized outcomes. Prospective studies are recommended to validate these findings. https://medicaljournalssweden.se/actadv/article/view/42465cicatricial alopecialichen planopilarisfrontal fibrosing alopeciainflammatory hair disorderhair losssystemic treatment
spellingShingle Mathias Willaert
Tristan van Dongen
Petra Dikrama
Tamar Nijsten
DirkJan Hijnen
Rick Waalboer-Spuij
Systemic Treatments for Lichen Planopilaris and Frontal Fibrosing Alopecia: A Retrospective Study of 315 Patients
Acta Dermato-Venereologica
cicatricial alopecia
lichen planopilaris
frontal fibrosing alopecia
inflammatory hair disorder
hair loss
systemic treatment
title Systemic Treatments for Lichen Planopilaris and Frontal Fibrosing Alopecia: A Retrospective Study of 315 Patients
title_full Systemic Treatments for Lichen Planopilaris and Frontal Fibrosing Alopecia: A Retrospective Study of 315 Patients
title_fullStr Systemic Treatments for Lichen Planopilaris and Frontal Fibrosing Alopecia: A Retrospective Study of 315 Patients
title_full_unstemmed Systemic Treatments for Lichen Planopilaris and Frontal Fibrosing Alopecia: A Retrospective Study of 315 Patients
title_short Systemic Treatments for Lichen Planopilaris and Frontal Fibrosing Alopecia: A Retrospective Study of 315 Patients
title_sort systemic treatments for lichen planopilaris and frontal fibrosing alopecia a retrospective study of 315 patients
topic cicatricial alopecia
lichen planopilaris
frontal fibrosing alopecia
inflammatory hair disorder
hair loss
systemic treatment
url https://medicaljournalssweden.se/actadv/article/view/42465
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AT petradikrama systemictreatmentsforlichenplanopilarisandfrontalfibrosingalopeciaaretrospectivestudyof315patients
AT tamarnijsten systemictreatmentsforlichenplanopilarisandfrontalfibrosingalopeciaaretrospectivestudyof315patients
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