Is there a gold standard therapeutic approach for classic lichen planopilaris?
This article presents two cases of erosive/ ulcerative oral lichen planus, who had not received any treatment before, treated with 630 nm low level laser. ... It usually occurs in middle-aged women, with a prevalence of 1 to 4%. Keratotic (white) ... Taylor CR. Low-dose excimer 308-nm laser for the treatment of oral lichen planus. Arch Dermatol ...
Does tumor necrosis factor α inhibitor cause lichen planopilaris?
Low-dose excimer 308-nm laser for treatment of lichen planopilaris. Low-dose excimer 308-nm laser for treatment of lichen planopilaris Arch Dermatol. 2011 Nov;147(11):1325-6. doi: 10.1001/archdermatol.2011.335. Authors Alexander A Navarini, Antonios G A Kolios, Bettina M Prinz-Vavricka, Susanne Haug, Ralph M Trüeb. PMID: 22106124 ...
Does laser treatment for oral lichen planus work?
Effectiveness of low-level laser therapy in lichen planopilaris J Am Acad Dermatol. 2018 May;78(5):1020-1023. doi: 10.1016/j.jaad.2017.11.040. Epub 2017 Dec 1. Authors Pablo Fonda-Pascual 1 ... Treatment Outcome Supplementary concepts Lichen planus follicularis ...
What is the best treatment for red lichen planus?
· Lichen planopilaris (LPP) is a relatively uncommon cutaneous disorder characterized by a chronic lymphocytic inflammation that leads to the selective destruction of hair follicles, thus resulting in scarring alopecia. 1 Some authors consider LPP as a follicular form of lichen planus, although only about 30% of patients present cutaneous or mucosal lesions of …
Is there any new treatment for lichen planopilaris?
Antimalarial Drug Plus Adalimumab Aids Hair Regrowth in Lichen Planopilaris. The combination of the biologic adalimumab and hydroxychloroquine may be responsible for the improvement in lichen planopilaris, including the hair regrowth, according to the study.
Can hair grow back after lichen planopilaris?
The hair loss is usually permanent. Although the condition cannot be cured, treatment aims to preserve the remaining hair and help to control symptoms but cannot cause regrowth of hair that has already been lost. How can lichen planopilaris be treated?
What is the best treatment for lichen planopilaris?
Antimalarial drugs are commonly used to treat lichen planopilaris. Hydroxychloroquine 200 mg twice daily is generally used and is often considered first-line systemic therapy. Improvement is usually seen within 6 months.
Can lichen planopilaris go into remission?
To make the situation even more complex, it is well known that lichen planopilaris (LPP) and other scarring alopecias can go through periods of activity and remission for many years and that in pseudopelade of Brocq, the hair loss is not associated with any apparent inflammation.
Is lichen planopilaris reversible?
Lichen planopilaris (LPP) and frontal fibrosing alopecia (FFA) are usually considered irreversible conditions and trichologic emergencies [1]. However, there are recently reported reversible cases of FFA and LPP with oral JAK inhibitors [2].
What causes lichen planopilaris to flare up?
Lichen planus can be triggered by: Hepatitis C infection. Flu vaccine. Certain pigments, chemicals and metals.
How I cured my lichen planus on scalp?
Lichen planus of the scalp must be treated right away, or the hair of the affected area may never grow back. Since every case of lichen planus is different, no one treatment does the job. Topical corticosteroids are very useful. You can use a corticosteroid ointment or cream that you apply directly to the bumps.
Why is my immune system attacking my hair follicles?
Alopecia areata is an autoimmune disease. This means that your immune system mistakenly attacks a part of your body. When you have alopecia areata, cells in your immune system surround and attack your hair follicles (the part of your body that makes hair).
How effective is hydroxychloroquine for lichen planopilaris?
Conclusions: Hydroxychloroquine is effective in decreasing symptoms and signs in LPP and FFA as shown by significant reduction in the LPPAI in 69% and 83% of patients after 6 and 12 months of treatment, respectively.
Does lichen planopilaris ever stop?
Lichen planus has no cure, but different treatments can help relieve your symptoms and speed healing. Possible treatments include: Antihistamine medicine to relieve itching.
Can PRP help lichen planopilaris?
Platelet-rich plasma is a promising new therapeutic strategy for individuals with lichen planopilaris and may improve hair thickening in affected areas. Additional controlled studies are warranted to elucidate the clinical benefit and optimal dosing strategies.
Does lichen planopilaris burnout?
Sometimes, after a period of time, lichen planopilaris can “burn out” and gets no worse. Once it has been stable for a number of years it may be possible for permanent areas of hair loss to be removed or reduced in size by a small operation.
How can I regrow my frontal hair loss?
There is no outright cure for a receding hairline, but there are some medications that can slow it down and help hair regrow.Finasteride or Dutasteride. ... Minoxidil.Anthralin. ... Corticosteroids. ... Hair transplants and laser therapy. ... Essential oils.
How do you reverse frontal hair loss?
The right treatment for you depends on the cause. “For androgenic alopecia, minoxidil (Rogaine) is the only FDA-approved medical treatment for both men and women,” Krejci says. It's a liquid or foam that you put on your scalp. Krejci says it can “help slow down or reverse hair loss in 75% of patients.”
Does LPP hair loss go away?
The aim of treatment is to slow progression of the disease and relieve symptoms. Hair loss may continue, although at a slower rate.
Does lichen planopilaris burnout?
Sometimes, after a period of time, lichen planopilaris can “burn out” and gets no worse. Once it has been stable for a number of years it may be possible for permanent areas of hair loss to be removed or reduced in size by a small operation.
What is lichen planus?
Lichen planus (LP) is a mucocutaneous disease of unknown etiology. T Lymphocytes are responsible for its pathogenesis [1]. It usually occurs in middle-aged women, with a prevalence of 1 to 4%. Keratotic (white) and non-keratotic (erosive/atrophic/ulcerative) forms has been described [2]. Keratotic lesions are usually asymptomatic and need no therapy, while red lesions need treatment for pain and soreness as well as their malignant potential [3-4]. Treating red oral lichen planus (OLP) is still a problem, and several empirical treatments have been used including corticosteroids, griseofulvin, curcuminoid, sulodoxide, oxypentifylline, as well as the surgery, photochemotherapy, and laser [5]. Local corticosteroid is the main treatment with promising outcomes in remission and pain/soreness relief [5-6]. The drug should be used intermittently, due to the chronicity of OLP lesions, and systemic therapy may occasionally be necessitated. Side effects are common with this treatment and include mucosal atrophy, candidiasis, adrenal suppression, gastrointestinal upset, hypertension, and hyperglycemia [7-8]. However, some patients are still resistant to this treatment. Therefore, novel effective treatments are being introduced. Low level laser therapy (LLLT) has recently been used for treating erosive OLP with minimal side effects [9-11].
What is LLLT laser?
LLLT is a recent evolution in medical/dental treatments, specifically regarding mucocutaneous lesions such as OLP [15-17]. Passeron et al. applied the 308 nm-excimer laser to treat erosive OLP in four patients with previous treatment failures. Twelve sessions were attended during six weeks, with the powers of 50- to 200 mJ/cm². One patient had half-part remission, two were non-responders and the other patient experienced exacerbation. The pain or soreness was not evaluated [9]. The present study showed lesion and pain remission by using a 630 nm laser, 10 sessions a month, with a power of 1.5 J/cm².
What is the difference between a 308 nm laser and a 630 nm laser?
These facts might explain the better outcomes of the present study. On the other hand, 308-nm excimer laser emits Ultraviolet B (UV-B) rays with a tissue penetration of less than 0.3 mm; whereas 630-nm red light laser penetrates tissue several millimeters deep with proven inflammation reduction, pain relief, and ulcer healing effects [15].
What are the effects of low level lasers on the body?
Physiologic effects of low level lasers on tissues are primary or secondary. Primary effects consist of vasodilatation, as well as enhancement of blood flow, lymph drainage, cellular metabolism, neutrophil and fibroblast activation, and pain stimulation thres hold. Secondary effects include aggregation of prostaglandins (such as prostaglandin E2), immunoglobulins and lymphokines, as well as beta-endorphin and encephalin in the tissue, resulting in reduction of inflammation, immune response, and pain, respectively [12-14]. Several low level lasers have been used to treat oral lichen planus, including ultraviolet (waves of below 350 nm length), Helium-Neon (632 nm), and more recently, diode (a spectrum of red to infrared wave lengths, 600 to 1100 nm) lasers. These lasers have been used with different wave lengths, intensities, powers, durations, number of sessions, and therapeutic approaches (with or without tissue absorbent) [9-11, 15]. This article presents two cases of erosive/ulcerative OLP treated via 630 nm low level laser.
Can a 630 nm laser be used for oral lichen planus?
In conclusion, erosive (ulcerative) oral lichen planus can be treated by 630 n m low level laser to decrease the pain and the soreness with no side effect. Further research with more participants and statistical analyses is necessary to evaluate LLLT as a novel therapeutic approach for OLP.
Is UV B laser a carcinogen?
Another advantage of this study was the absence of any side effect. The UV-B excimer laser is potentially carcinogen. Besides, erythema, erosion, and soreness are other probable side effects of its use [11]. No side effect has been reported with red laser application [16-17].
Can OLP be treated with corticosteroids?
Erosive/ulcerative OLP is a potentially premalignant lesion which can interfere with eating or speaking [4]. Although corticosteroids are the first line of treatment, they are not approved totally because of their side effects. Diphenhydramine or other local anesthetics might be used in conjunction with corticosteroids, as well as antifungal agents to manage Candidiasis. This multi-drug regimen reduces the patient compliance.
What is the most specific feature of dermoscopy of LPP?
The dermoscopy of LPP displays several features, with the most specific finding of active lesions being perifollicular scaling form ing a sort of “ collar” on the proximal portion of the hair shaft. Late lesions may show fibrotic white dots, acquired pili torti, loss of follicular openings, white areas, honeycomb/scattered hyperpigmentation, milky red areas, and hair tufts.5
What is LPP in dermatology?
Lichen planopilaris (LPP) is a relatively uncommon cutaneous disorder characterized by a chronic lymphocytic inflammation that leads to the selective destruction of hair follicles, thus resulting in scarring alopecia.1Some authors consider LPP as a follicular form of lichen planus, although only about 30% of patients present cutaneous or mucosal lesions of lichen planus.2
What is LPP in alopecia?
LPP classically presents as follicular keratotic plugs and/or perifollicular scaling along with perifollicular erythema, with subsequent hair loss resulting in patchy alopecic areas.1,2Of note, in acute phases, LPP patients may experience pruritus, pain, and/or burning sensation, differently from other primary scarring alopecias.1,2Besides classic LPP, there are two main clinical variants, viz. frontal fibrosing alopecia and Graham-Little–Piccardi–Lasseur syndrome, with the former presenting with a progressing band of alopecia of the hairline in postmenopausal women and the latter being characterized by the triad of scarring patchy alopecia of the scalp, nonscarring alopecia of the axillae/pubic region, and spinous follicular papules of the trunk/limbs.1,3,4
How common is LPP in women?
LPP is more common in women than in men (ratio varying from 1.8:1 to 9:1), and the peak age of onset is observed between 30 and 60 years.1–4
What is differential diagnosis of LPP?
The main differential diagnoses of LPP include discoid lupus erythematosus, alopecia areata, centrifugal cicatricial alopecia, and folliculitis decalvans.1 –5A good physical assessment, along with dermoscopic and histological examination, is important to distinguish LPP from such conditions.1–5
When does LPPAI decrease?
Significant LPPAI decrease at months 2 and 4, with only erythema showing significant improvement at month 6 compared with the baseline. Three withdrawn patients
What is the best treatment for LPP?
Oral cyclosporine is probably the most helpful treatment for LPP overall but rarely we start with this due to side effects (it's viewed as a “third-line option” in my pratice). It may help up to 80 % of patients. The next best is probably methotrexate and hydroxychloroquine with up to 60 % benefiting.
Can you get LPP with platelet rich plasma?
Starting with treatments like platelet rich plasma for LPP is common but not based on solid evidence. Rarely do patients really benefit. Over the counter supplements don't shut down the disease and are not first line either. Hair transplantation for LPP can be done but only when the disease is 100 % quiet (patient has no symptoms and has not lost any hair and taken no medications) and has shown itself to be 100 % quiet over 2 years of extremely careful monitoring. If photos of a patient taken two years apart look identical, a patient with LPP may be a candidate for surgery. Even then the disease can still flare and long term dermatological monitoring is needed.
Can LPP be done with hair transplant?
Hair transplantation for LPP can be done but only when the disease is 100 % quiet (patient has no symptoms and has not lost any hair and taken no medications) and has shown itself to be 100 % quiet over 2 years of extremely careful monitoring.
Does Lichen Planopilaris cause hair loss?
Lichen planopilaris is a scarring alopecia with the potential to cause permanent hair loss . Treatment helps stop the disease in many but may or may not actually help the hair to grow back. Treatment, however, may help reduce symptoms such as scalp itching, burning or tenderness.