SnapshotDx Quiz: December 2018

November 2018 in “ Journal of Investigative Dermatology ”

Fabrizio Galimberti, Preetha Kamath, Mariya Miteva

Lichen Planopilaris cicatricial alopecia immune privilege hair follicle bulge epithelial stem cells CD8+ T cells interferon-gamma epithelial-to-mesenchymal transition peroxisome proliferator-activated receptor-gamma LPP scarring alopecia eSC IFN-γ EMT PPAR-γ

TLDR Lichen Planopilaris causes irreversible hair loss due to immune attacks on hair stem cells, but modulating PPAR-γ might help treat it.

The document discussed a quiz from the Journal of Investigative Dermatology focusing on diagnosing hair and scalp conditions, with the correct diagnosis being Lichen Planopilaris (LPP), a type of cicatricial alopecia leading to irreversible hair loss. It highlighted the immune privilege of the hair follicle bulge, which contains epithelial stem cells (eSC) protected from autoimmune attacks. In LPP, this privilege was compromised, making eSC vulnerable to destruction by CD8+ T cells, with interferon-gamma (IFN-γ) playing a role in this process. The document also explored the epithelial-to-mesenchymal transition (EMT) and the role of peroxisome proliferator-activated receptor (PPAR)-γ in maintaining hair follicle health, suggesting that PPAR-γ modulation could potentially reverse early EMT changes, offering insights into therapeutic approaches for LPP.

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Research cited in this study

15 / 15 results

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PPAR-γ agonists like pioglitazone may help manage lichen planopilaris but don't fully reverse scarring.

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research Clinicopathologic Lessons in Distinguishing Cicatricial Alopecia: 7 Cases of Lichen Planopilaris Misdiagnosed as Discoid Lupus

15 citations , September 2014 in “Journal of The American Academy of Dermatology”

Seven patients were misdiagnosed with discoid lupus instead of lichen planopilaris due to similar symptoms, showing the need for careful diagnosis in scarring hair loss conditions.

research A Case Series of 46 Patients With Lichen Planopilaris: Demographics, Clinical Evaluation, and Treatment Experience

47 citations , June 2014 in “Journal of Dermatological Treatment”

Most treatments for lichen planopilaris were found to be generally unsatisfactory.

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research Lichen Planopilaris Is Characterized By Immune Privilege Collapse Of The Hair Follicle's Epithelial Stem Cell Niche

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Lichen planopilaris may be an autoimmune disease causing hair loss due to immune system issues in hair follicles.

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New insights show Lichen Planopilaris is a rare, scarring hair loss condition, hard to treat, mainly affecting middle-aged women, and significantly impacts mental health.

research Lichen Planopilaris: Chronic Scarring Alopecia with Autoimmune Component

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Lichen planopilaris is a chronic, scarring hair loss condition with no definitive cure, requiring accurate diagnosis and treatment to manage symptoms.

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Scalp biopsies are crucial for diagnosing hair loss conditions like Diffuse Unpatterned Alopecia (DUPA) and retrograde hair loss, as treatments like finasteride and dutasteride may not be effective if other conditions are present. Combining PPAR-GAMMA agonists with retinoids could improve treatments for conditions like Lichen Planopilaris.

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Prostaglandin balance affects hair loss, particularly in conditions like Lichen Planopilaris, where an imbalance can lead to hair follicle damage. Treatments mentioned include prostaglandin analogs and Pioglitazone HCL, with a focus on maintaining prostaglandin equilibrium for potential hair regrowth.

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Lichen Planopilaris (LPP), a form of permanent hair loss, which can be mistaken for seborrheic dermatitis and is characterized by scalp itching, burning, redness, and dandruff. Treatment options discussed include steroidal creams, finasteride, minoxidil, and RU58841.

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Lichen Planopilaris (LPP) is an autoimmune condition causing permanent hair loss and fibrosis, often misdiagnosed. Treatments include pioglitazone, topical corticosteroids, anti-inflammatory medication, and Jak inhibitors.

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