Systemic Treatments for Lichen Planopilaris and Frontal Fibrosing Alopecia: A Retrospective Study of 315 Patients

    April 2025 in “ Acta Dermato Venereologica
    Mathias Willaert, Tristan Van Dongen, Petra Dikrama, Tamar Nijsten, DirkJan Hijnen, Rick Waalboer‐Spuij
    TLDR Methotrexate is best for lichen planopilaris, and retinoids are best for frontal fibrosing alopecia, but side effects are common.
    This retrospective study analyzed the effectiveness of systemic treatments for lichen planopilaris and frontal fibrosing alopecia in 315 patients, predominantly female, treated at Erasmus University Medical Center. Hydroxychloroquine was the most commonly used treatment, but methotrexate showed the highest response rate for lichen planopilaris (79.2%), and retinoids for frontal fibrosing alopecia (73.9%). Despite their effectiveness, cyclosporine A and retinoids had higher discontinuation rates due to side effects. The study suggests methotrexate and cyclosporine A for lichen planopilaris, and cyclosporine A and retinoids for frontal fibrosing alopecia, but highlights the need for prospective studies due to limitations like the retrospective design and lack of standardized outcomes.
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