Hydroxychloroquine and lichen planopilaris: Efficacy and introduction of Lichen Planopilaris Activity Index scoring system
Accepted 14 August 2009. published online 11 January 2010.
Refers to article:
Commentary: Treatment of lichen planopilaris: Some progress, but a long way to go
, 11 January 2010
Leonard C. Sperling, Jennifer V. Nguyen
Journal of the American Academy of Dermatology
March 2010 (Vol. 62, Issue 3, Pages 398-401) Full Text |
Full-Text PDF (136 KB)
Background
Lichen planopilaris (LPP) and its variant frontal fibrosing alopecia (FFA) are primary lymphocytic cicatricial alopecias for which there is no evidence-based therapy.
Objective
We assessed the efficacy of hydroxychloroquine in active LPP and FFA using the LPP Activity Index (LPPAI), a numeric score that allows quantification of the symptoms and signs of the condition for statistical comparison. In addition, we determined with the LPPAI if any improvement (reduction) in the numeric score pretreatment and posttreatment reached statistical significance.
Methods
This was a retrospective, single-center chart review of 40 adult patients with LPP, FFA, or both who were treated with hydroxychloroquine for up to 12 months from 2004 to 2007 at the University of California, San Francisco Hair Center. Symptoms, signs, activity, and spreading were scored at each visit in the standardized cicatricial alopecia flow chart. A numeric score was assigned to these markers of disease activity and a numeric score was calculated at each visit.
Results
There was significant reduction (P < .001) in the LPPAI at both 6 and 12 months. After 6 months, 69% had improved (reduced) symptoms and signs. At 12 months, 83% had improvement (reduction) in symptoms and signs.
Limitations
Retrospective analysis and uncontrolled study are limitations.
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.
aDepartment of Dermatology at University of California, San Francisco, California
bPalo Alto Medical Foundation, Fremont Center, Fremont, California
cDepartment of Dermatology at Palo Alto Medical Foundation, Camino Medical Group, Mountain View, California
dDepartment of Dermatology at Baylor College of Medicine, Houston, Texas
Reprint requests: Vera H. Price, MD, Department of Dermatology at University of California, San Francisco, 1701 Divisadero St, Third Floor, San Francisco, CA 94143.
ABSTRACT