P8.148 CICATRICIAL ALOPECIA / LICHEN PLANOPILARIS- THE CLEVELAND CLINIC FOUNDATION EXPERIENCE ON EVALUATION, DIAGNOSIS AND TREATMENT

Wilma F. Bergfeld, M.D.*; Berna K. Remzi, M.D.*; Nathaniel C. Cevasco, B.S.**

*Department of Dermatology, The Cleveland Clinic Foundation, Cleveland, OHIO, USA, **The Medical College of Ohio, School of Medicine, Toledo, OHIO, USA

Background: The cicatricial or scarring alopecias are a diverse group of cutaneous disorders with various clinical presentations, etiology, and pathogenesis. Lichen planopilaris, the term most widely used to describe the clinical syndrome of lichen planus associated with cicatricial scalp alopecia, results in scaling, atrophy, and permanent alopecia with scarring and is thought to be autoimmune in origin.

Objectives: To evaluate the clinical findings of patients with cicatricial alopecia/lichen planopilaris in an attempt to standardize the evaluation and diagnosis of the disease and to review the current effective therapies.

Methods: We reviewed the medical records of 29 patients with cicatricial alopecia that were seen in the Department of Dermatology at The Cleveland Clinic Foundation between 1992 and 2003, performing descriptive analyses and Fisher’s Exact Test on the data that was collected. Twenty-seven of the patients were women (93%) and two (7%) were men.

Results: Middle-aged women were more commonly affected and had the disease for an average of 41.96 + 37.91 months. Most patients were affected on the parietal area of the scalp and commonly experienced follicular hyperkeratosis (69%), pruritus (66%), perifollicular erythema (62%) and scalp pain (55%). All patients received treatment combinations. The most common treatments prescribed were ketoconazole shampoo (86%), topical steroids (83%), multivitamin/biotin (76%) and intralesional steroids (69%). Relatively good responses in the active perimeter were seen with topical steroids, intralesional steroids and tetracycline and in the inactive end stage with hair transplants and scalp reductions.