A Review of Metabolic Dysregulation in Lymphocytic Cicatricial Alopecia: Exploring the Connections and Therapeutic Implications

March 2025 in “ Journal of Investigative Dermatology ”

Aaron Bao, Lindsey A. Bordone, Crystal Aguh

lymphocytic primary cicatricial alopecia metabolic dysregulation diabetes dyslipidemia peroxisome proliferator-activated receptor γ adenosine monophosphate-activated protein kinase pioglitazone metformin glucagon-like peptide-1 agonists PPARγ AMPK GLP-1 agonists

TLDR Metabolic issues may trigger lymphocytic cicatricial alopecia, and treatments targeting these issues could help.

This review discusses the link between lymphocytic primary cicatricial alopecia (LPCA) and metabolic dysregulation, such as diabetes and dyslipidemia, suggesting that metabolic dysfunction might be a primary trigger for LPCA. It identifies disruptions in metabolic pathways, including peroxisome proliferator-activated receptor γ signaling and adenosine monophosphate-activated protein kinase activation, in affected hair follicles. Preliminary treatments like pioglitazone and metformin show potential in normalizing lipid metabolism and reducing inflammation. The review recommends metabolic screening for LPCA patients and considers therapies like glucagon-like peptide-1 agonists to enhance treatment outcomes.

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