Lichen planopilaris in women: A survey-based study examining baseline hair characteristics and product use in 129 patients seen at Mayo Clinic

• Main Authors: Raevti Bole, MD, Saranya Wyles, MD, PhD, Sydney Larkin, BA, Reese Imhof, BA, Rochelle R. Torgerson, MD, PhD
• Format: Article
• Language: English
• Published: Elsevier 2020-03-01
• Series: International Journal of Women's Dermatology
• Online Access: http://www.sciencedirect.com/science/article/pii/S2352647519301121

Background: Cicatricial alopecia is a type of permanent hair loss in which the hair follicle is replaced by scar tissue. Given its relatively low incidence, limited information is available regarding baseline hair characteristics, onset, and other disease-associated factors. Objective: We sought to further elucidate this information in our lichen planopilaris (LPP) patients. Methods: Between 1993 and 2016, 505 patients were diagnosed with biopsy-proven LPP. Of these patients, we mailed a 20-question survey to 420 patients with updated mailing address and contact information. Responses were received from 129 of 420 patients for a response rate of 30.7%. A total of 108 patients completed the survey and 21 patients declined participation. Descriptive analysis was performed using JMP software. Results: Median age at time of pathologic diagnosis was 58 years, with self-reported average age of onset accordingly from 50 to 60 years. Approximately 15% of patients were diagnosed with frontal fibrosing alopecia (FFA), a subtype of LPP. Median follow-up from date of pathologic diagnosis was 72 months. At baseline, 46 out of 108 patients (42.6%) endorsed having thicker hair than peers in childhood. No trend was identified in the rate of traction hairstyle use in childhood, current use of cosmetics, sunscreen, or facial cleanser. Conclusions: Within our LPP cohort, FFA subtype pathology comprised approximately 15% of cases. There was no trend toward sunscreen use and FFA subtype. Our findings support previously published studies in terms of average age at disease onset, location of hair loss, and median follow-up at 72 months (range: 29–273) from date of pathologic diagnosis. Keywords: Lichen planopilaris, Frontal fibrosing alopecia, Natural history, Survey, Sunscreen, Facial cosmetics