From the Research
Lichen planopilaris (LPP) is a chronic inflammatory condition that typically does not resolve completely on its own and may persist for years to decades without treatment, with the average duration of active disease ranging from 1-7 years in most cases, though some patients may experience activity for 10 years or longer, as reported in a study from 1. The average duration of LPP before resolution is highly variable and can range from a few months to several years.
- The study from 1 reported that the average age of patients with LPP was 43.75 ± 13.51 years, and the average duration of the disease was not specified, but the study focused on the treatment outcomes.
- Another study from 2 reported an average duration of 13 months at the time of diagnosis, but this study is older and may not reflect the current understanding of the disease.
- A more recent study from 3 reported on the characteristics and treatment of 291 patients with LPP, but did not provide information on the average duration of the disease.
- The study from 4 reported that the remission rate was 6.5% after 3 months and 33% after 18 months, indicating that the disease can persist for a long time without treatment.
- The study from 5 reported on the use of low-level light therapy for the treatment of LPP, and found that it was effective in reducing inflammation and promoting hair regrowth, but did not provide information on the average duration of the disease.
- The study from 1 reported that platelet-rich plasma (PRP) therapy was effective in reducing the LPP Activity Index (LPPAI) and improving patient satisfaction, and may be a new and effective choice for the treatment of LPP.
The treatment of LPP aims to control inflammation rather than cure the condition, with most patients requiring 6-12 months of therapy before achieving disease stabilization, as reported in the example answer. The treatment options for LPP include:
- Potent topical corticosteroids
- Intralesional steroid injections
- Systemic medications like hydroxychloroquine (200-400mg daily)
- Oral retinoids
- Mycophenolate mofetil
- Cyclosporine for refractory cases
- Platelet-rich plasma (PRP) therapy
- Low-level light therapy
Even after clinical improvement, maintenance therapy is often necessary to prevent recurrence, and patients should understand that the hair loss from scarring is permanent.
- The study from 3 reported that the response rates of cyclosporine (CSP) and methotrexate (MTX) were highest, 100% and 85%, respectively, but these treatments were less safe compared with mycophenolate mofetil (MMF).
- The study from 1 reported that PRP therapy was well-tolerated and effective in reducing the LPPAI and improving patient satisfaction.