Prevalence, Treatment Patterns of Lichen Planopilaris: A Cross-Sectional Study

TOPLINE:

A cross-sectional study provided information on the prevalence of lichen planopilaris (LPP), a type of scarring alopecia, among US adults seeing a dermatologist and the most common treatments prescribed.

METHODOLOGY:

• Researchers utilized the Explorys database to conduct a cross-sectional study on LPP prevalence and treatment patterns in the United States.
• For the prevalence analysis, they analyzed data from 1,466,832 patients, identifying 241 adults diagnosed with LPP between 2017 and 2019.
• Treatment patterns were evaluated among 991 patients diagnosed with LPP between 2016 and 2020 who saw a dermatologist at least once within a year of diagnosis, focusing on treatments within that first year.

TAKEAWAY:

• The standardized prevalence of LPP in US adults was 13.4 per 100,000. Prevalence was higher among women (22.7 per 100,000 vs 2.9 per 100,000 among men) and people in older age groups (prevalence was highest among those aged 70-79 years, at 25.8 per 100,000).
• As for treatment patterns, most (64.1%) received at least one type of medication. Intralesional corticosteroids (37.3%) and topical corticosteroids (34.5%) were the most common, followed by oral doxycycline (10.5%) and hydroxychloroquine (7.3%).
• With 1 year of follow-up, continuation of treatment was highest among those taking an intralesional corticosteroid (35.5%) and those prescribed hydroxychloroquine (24.1%).
• Many patients also received two types (13.8%) and three types (7.5%) of treatment, and at 1 year, 12.6% of patients initially prescribed an intralesional corticosteroid and 22.7% of those initially prescribed a topical corticosteroid had switched treatment.

IN PRACTICE:

Noting that evidence for the treatment of LPP is “primarily based on case reports and case series,” the authors wrote that in the future, “research is needed to optimize treatment regimens and develop new, targeted therapies for patients with LPP to limit its morbidity and permanent sequelae.”

SOURCE:

The study was led by Natalia Pelet del Toro, MD, of the Department of Dermatology, Northwell Health, New Hyde Park, New York, and was published online on June 12, 2024, in JAMA Dermatology.

LIMITATIONS:

Missing data and potential miscoding could affect the accuracy of LPP diagnoses, and reliance on ICD-10 codes for LPP diagnoses might not capture all cases, especially subtypes sharing the same code. The study’s findings were based on a healthcare-seeking population, which may not represent the general population.

DISCLOSURES:

One author reported being an adviser for and receiving honoraria from multiple pharmaceutical companies; another author reported being an adviser and receiving honoraria and/or research grants from multiple pharmaceutical companies. Pelet del Toro and another author had no disclosures.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.