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Journal of the American Academy of Dermatology
Volume 62, n° 3
pages 393-397 (mars 2010)
Doi : 10.1016/j.jaad.2009.05.018
accepted : 3 May 2009
Original Articles

Efficacy and safety of mycophenolate mofetil for lichen planopilaris
 

Bryan K. Cho, MD, PhD a, Deborah Sah, MD b, Jennifer Chwalek, MD c, Ingrid Roseborough, MD d, Blanca Ochoa, MD e, Charles Chiang, MD f, Vera H. Price, MD f,
a Department of Dermatology, Palo Alto Medical Foundation, Mountain View, California 
b Urgent Care, Palo Alto Medical Foundation, Fremont, California 
c Department of Dermatology, Kaiser Medical Group, Union City, California 
d Department of Dermatology, University of Iowa Hospitals and Clinics, Iowa City, Iowa 
e Department of Dermatology, Baylor College of Medicine, Houston, Texas 
f Department of Dermatology, University of California, San Francisco, California 

Reprint requests: Vera H. Price, MD, Department of Dermatology, University of California, San Francisco, 1701 Divisadero St, Third Floor, San Francisco, CA 94143.
Abstract
Background

Lichen planopilaris (LPP) is a chronic inflammatory disorder that causes permanent scalp hair loss and significant patient discomfort.

Objectives

We sought to determine the efficacy and safety of mycophenolate mofetil (MMF) for treatment of LPP in patients who had failed prior topical, intralesional, or oral anti-inflammatory medications such as hydroxychloroquine or cyclosporine.

Methods

We conducted a retrospective chart review of 16 adult patients with LPP treated with at least 6 months of MMF in an open-label, single-center study from 2003 to 2007. Subjective and objective end points were quantified using the LPP Activity Index (LPPAI) and scores before and after treatment were assessed using a paired t test. Adverse events were monitored.

Results

Patients who completed treatment with MMF had significantly decreased signs and symptoms of active LPP despite having failed multiple prior therapies (P < .005). Five of 12 patients were complete responders (LPPAI score decreased>85%), 5 of 12 patients were partial responders (LPPAI score decreased 25%-85%), and two of 12 patients were treatment failures (LPPAI score decreased<25%). Four patients withdrew from the trial because of adverse events.

Limitations

Retrospective analysis and small sample size were limitations.

Conclusions

MMF was effective at reducing the signs and symptoms of active LPP in 83% of patients (10 of 12) who had failed multiple prior treatments after at least 6 months of treatment.

The full text of this article is available in PDF format.

Key words : lichen planopilaris, Lichen Planopilaris Activity Index, mycophenolate mofetil

Abbreviations used : LPP, LPPAI, MMF



 Funding sources: None.
 Conflicts of interest: None declared.

  Chiang C, Sah D, Cho BK, Ochoa BE, Price VH. Hydroxychloroquine and lichen planopilaris: Efficacy and introduction of Lichen Planopilaris Activity Index scoring system. J Am Acad Dermatol 10.1016/j.jaad.2009.08.054.


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