|
|
L12. Oral ciclosporin
in lichen planopilaris. Lichen planopilaris (LPP) is a rare inflammatory disease that causes permanent
alopecia. When the disease is very active the best treatment is oral corticotherapy,
but relapse is frequent. A short course of oral cyclosporine has been reported
successful in treating 3 patients.
We present 12 patients with refractory LPP treated for 3 to 7 months with cyclosporine.
They were aged from 31 to 59 years with a diagnosis of LPP from 1 to 19 years.
Previous treatment included topical and intralesional corticosteroids, hydroxychloroquine,
chloroquine, topical tacrolimus and oral corticotherapy (n=5). At the beginning
of the study, the dosage of cyclosporine was 3mg/kg/Day, increased monthly
in case of non-response. Treatment was stopped after 2 months without symptoms.
In a few patients we measured hair density on a selected target and performed
global standardized photography.
We obtained complete clinical resolution of the disease activity at doses ranging
from 250mg to 400mg, and treatment duration of 4 to 8 months. A complete clinical
response was achieved in 8 patients and a partial response in 2. Two patients
failed to respond. Six months after stopping cyclosporine 6 patients remained
symptom free and 4 had relapsed. Hair count was available before and after
treatment for 9 patients with stabilisation (n=4), increase (n=3) or decrease
(n=2). The two patients with a decrease were clinically rated failure or partial
response.
Side effects were minor: these included transient elevation of serum creatinine
(n=4), distal paresthesia (4), and hypertrichosis (2). On the basis of this experience: |
|||
|
|
|||