145 Hydroxychloroquine Sulfate’s Ineffectiveness in the Treatment of Lichen Plano-pilaris and Idiopathic Pseudopelade

C. Jouanique, P. Reygagne, P. Assouly, B. Matard, E. Marechal, H. Bachelez and L. Dubertret. Center Sabouraud, Saint-Louis Hospital, Paris, France.

Regardless of its etiology, the treatment of pseudopelade is difficult. Previously we have tried using acitretine or thalidomide, without success. Antimalarials are commonly used to treat lichen planus and chronic discoid lupus erythematosus. Nine patients with progressive pseudopelade were included. The average age was 54,9 years (range 35 to 73). There were 6 women and 3 men. In 4 cases diagnosis was lichen plano-pilaris, in 4 cases idiopathic pseudopelade and in 1 case it remained uncertain between lupus and lichen. Hydroxychloroquine sulfate was administered at 400 mg daily for 6 months. Patients were examinated every 2 months, including each time : a clinical examination, a standardised global photography (using Canfield’s method) and hair count around a previously small shaven area with a central tattoo (using macrophotography). The standard photographies and the hair count using macrophotographies were the two principal criteria used in evaluating the treatment’s efficiency. Using the standard photographies 3 cases were considered as stabilised and 6 as worsened. None was improved. After 6 month’s treatment the hair count using the macrophotographies showed an average hair loss of 21% (range -4,5% to -53,3%). Tolerance was good. This was a small open study with only 9 patients. Based on subjective evaluation using standard photographies only 3 patients were considered as stabilized, while others were noted as aggravated. However, in these 3 apparently stabilized patients, the hair counts revealed respective hair losses of -15,4%, -4,5% and -4,8%. The first case was an idiopathic pseudopelade and the other two were lichen plano-pilaris. Although there was no control group in this study, hydroxychloroquine sulfate does not seem efficient in controlling the progression of lichen plano-pilaris of the scalp.