RESUMO
INTRODUCTION: Lichen planopilaris (LPP) is a common type of primary cicatricial alopecia. Previous studies focused on the epidemiology, clinical characteristics, and treatment of LPP. A lack of knowledge regarding LPP outcomes and prognostic factors remained. METHODS: To delineate the rate and timing of remission in LPP, as well as the prognostic factors for achieving remission, a retrospective cohort study was conducted. The study included 126 patients, from a single tertiary center, diagnosed with LPP between January 2010 and December 2022, who were followed up for a minimum of 6 months. RESULTS: There were 89 (70.6%) women and 37 (29.4%) men included in this study. The mean age of the patients was 47.92 ± 14.2 years. The mean time from disease onset to diagnosis was 33.85 (±30) months, indicating significant diagnostic delays. The mean duration of follow-up was 34.13 ± 22.7 months. Among the cohort, 43 patients achieved complete remission (CR) during the follow-up period, whereas 83 patients did not. Of the 83 patients who did not achieve CR, 35 partially improved and 48 did not improve or worsened. The median time for achieving CR was 46 ± 18.8 months. Milder disease at presentation and comorbid lichen planus were associated with higher CR rates. CONCLUSION: This study demonstrates significant diagnostic delays that should be addressed as LPP causes irreversible alopecia, suggests disease severity and comorbid lichen planus as potential prognostic factors. Further, it emphasizes the limited efficacy of current treatments and the need for prolonged treatment in patients with LPP to achieve remission.
Assuntos
Alopecia , Líquen Plano , Indução de Remissão , Humanos , Feminino , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Líquen Plano/epidemiologia , Líquen Plano/tratamento farmacológico , Líquen Plano/complicações , Prognóstico , Adulto , IdosoAssuntos
Asma , Líquen Plano , Rinite Alérgica , Humanos , Estudos Transversais , Asma/complicações , Asma/epidemiologia , Masculino , Feminino , Líquen Plano/complicações , Líquen Plano/patologia , Líquen Plano/epidemiologia , Rinite Alérgica/epidemiologia , Rinite Alérgica/complicações , Adulto , Pessoa de Meia-Idade , Estados Unidos/epidemiologia , Adulto Jovem , Adolescente , IdosoRESUMO
Importance: Lichen planopilaris (LPP) is a form of scarring alopecia associated with progressive, permanent hair loss. Symptoms range from burning pain to itching, also carrying substantial psychological morbidity. Yet, disease characteristics, pathophysiology, and effective treatment data are limited, making treatment a challenge. Objective: To describe the prevalence and dermatologist-prescribed treatment patterns of LPP among US adults. Design, Setting, and Participants: This cross-sectional study used the Explorys database. The prevalence analysis used a 15% random sample and identified US adults with LPP diagnoses between 2017 and 2019. The LPP treatment analysis included all patients with LPP diagnoses between 2016 and 2020 and a dermatologist encounter in the first year after diagnosis. Data were analyzed from January 2023 to April 2023. Main Outcomes and Measures: The main outcomes of the prevalence analysis were the crude and standardized prevalence estimates of US adults with LPP across age, sex, and racial groups. The main outcomes of the treatment analysis were the frequency of LPP treatments within 1 year of diagnosis, and the number of patients who continued treatment beyond 1 year, switched treatments, and combined treatments. Results: Among 1â¯466â¯832 eligible patients analyzed for prevalence, 241 patients had an LPP diagnosis (222 [92.1%] female; median [IQR] age, 64 [54-73] years). Standardized overall prevalence was 13.4 per 100â¯000 (95% CI, 11.7-15.1). In the treatment analysis, 991 patients had an LPP diagnosis (907 [91.5%] female; median (IQR) age, 60 [47-69] years). Most received at least 1 type of medication (635 [64.1%]), most frequently intralesional corticosteroids (370 [37.3%]) and topical corticosteroids (342 [34.5%]), followed by doxycycline (104 [10.5%]) and hydroxychloroquine (72 [7.3%]). Treatment continued beyond 1 year in 71 of 200 patients (35.5%) prescribed intralesional corticosteroids and 7 of 29 patients (24.1%) prescribed hydroxychloroquine. Treatment switching at 1 year occurred in 32 of 254 patients (12.6%) first prescribed an intralesional corticosteroid and in 44 of 194 (22.7%) first prescribed a topical corticosteroid. Combinations of 2 or 3 treatment types were given to 137 (13.8%) and 74 (7.5%) patients, respectively. Conclusions and Relevance: This cross-sectional study reported prevalence and treatment patterns for US adults with LPP in a representative sample. Most patients with LPP received treatment, and many received multiple treatment types and switched treatments, suggesting further research into medication selection offers clinical benefit.
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Alopecia , Líquen Plano , Humanos , Feminino , Masculino , Pessoa de Meia-Idade , Estudos Transversais , Prevalência , Líquen Plano/epidemiologia , Líquen Plano/tratamento farmacológico , Adulto , Idoso , Estados Unidos/epidemiologia , Alopecia/epidemiologia , Alopecia/tratamento farmacológico , Adulto Jovem , Padrões de Prática Médica/estatística & dados numéricos , Adolescente , Fármacos Dermatológicos/administração & dosagem , Fármacos Dermatológicos/uso terapêuticoAssuntos
Dermatite Alérgica de Contato , Líquen Plano , Lúpus Eritematoso Cutâneo , Humanos , Líquen Plano/diagnóstico , Líquen Plano/epidemiologia , Dermatite Alérgica de Contato/diagnóstico , Dermatite Alérgica de Contato/epidemiologia , Dermatite Alérgica de Contato/etiologia , Feminino , Lúpus Eritematoso Cutâneo/diagnóstico , Lúpus Eritematoso Cutâneo/epidemiologia , Masculino , Pessoa de Meia-Idade , Bases de Dados Factuais/estatística & dados numéricos , Adulto , Estados Unidos/epidemiologia , Idoso , Fatores de RiscoAssuntos
Alopecia , Bases de Dados Factuais , Líquen Plano , Humanos , Alopecia/epidemiologia , Alopecia/patologia , Líquen Plano/epidemiologia , Líquen Plano/patologia , Prevalência , Estados Unidos/epidemiologia , Feminino , Masculino , Pessoa de Meia-Idade , Bases de Dados Factuais/estatística & dados numéricos , Adulto , Idoso , Fibrose/epidemiologia , Adulto Jovem , AdolescenteRESUMO
Introducción: El liquen plano (LP) es una enfermedad inflamatoria crónica, de etiología desconocida, que puede afectar la piel, los anexos y las mucosas. Objetivo: Describir las características epidemiológicas y clínicas y el tratamiento realizado en los pacientes con diagnóstico clínico e histopatológico de LP, valorados en el Servicio de Dermatología del Hospital de Pediatría "Prof. Dr. Juan P. Garrahan" en los últimos 33 años. Diseño:Estudio descriptivo, retrospectivo y transversal. Materiales y métodos: Se revisaron las historias clínicas de los pacientes con diagnóstico histopatológico de LP atendidos en el Hospital desde agosto de 1987 hasta febrero de 2020 y se analizaron las variables epidemiológicas, clínicas y de tratamiento. Resultados: Se incluyeron datos de 26 pacientes, 18 de los cuales eran varones (69,3%). La media de edad en el momento del diagnóstico fue de 9,6 años. Presentaron la variedad de LP clásico 24 pacienes (93%). El compromiso ungueal y de la mucosa bucal se observó en 2 pacientes (7,7%). Ninguno tuvo asociación a fármacos ni a infecciones. En cuanto al tratamiento recibido, 4 pacientes (15,4%) tuvieron pérdida del seguimiento; 13 (50%) realizaron tratamiento tópico; 6 (23%), tratamiento sistémico y 3 (11,5%), tratamiento combinado. El promedio de seguimiento fue de 6 meses y se obtuvo una respuesta favorable en el 68% de los pacientes. Conclusiones: El LP es una patología de baja frecuencia en la infancia. No se encontró asociación a medicamentos ni a enfermedades infecciosas como se describe en la población adulta. Su curso es crónico y, en los pacientes que tuvieron un adecuado seguimiento, se obtuvo una buena respuesta al tratamiento indicado.
Introduction: Lichen planus (LP) is a chronic, inflammatory disease of unknown etiology, which can affect skin, adnexal tissues and mucosa. Objective: to describe the clinical, epidemiological characteristics and the treatment received by patients with clinical and histopathological diagnosis of LP, seen at the Dermatology Service of Pediatric Hospital "Prof. Dr. Juan P. Garrahan" in the last 33 years. Design: Descriptive, retrospective and cross-sectional study. Materials y methods: We reviewed the clinical history of patients with histopathological diagnosis of LP that were treated at our hospital from August 1987 to February 2020 and analysed the epidemiological, clinical and treatment variables. Results: Data of 26 patients were included in this study 18 of which are males (69.3%). The mean age of diagnosis was 9.6 years. 24 patients (93%) presented the classical type of LP. Ungual and mucosal compromise were observed in 2 patients (7.7%) and none had associations with infections or drugs. Regarding treatment, 4 patients (15.4%) did not continue follow-ups, 13 patients (50%) had topical treatment, 6 (23%) had systemic treatment and 3 patients (11.5%) received combined treatment. The average follow-up time was 6 months and 68% of patients had favorable outcome. Conclusions: LP is an uncommon pathology in children. During this study we did not find any etiologic relations with use of drugs or infectious diseases as is described in de adult population. Its course is chronic and in the patients that had a proper follow-up a good response to the indicated treatment was obtained.
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Humanos , Masculino , Feminino , Pré-Escolar , Criança , Adolescente , Líquen Plano/epidemiologia , Fototerapia , Argentina/epidemiologia , Estudos Transversais , Estudos Retrospectivos , Corticosteroides/uso terapêutico , Líquen Plano/diagnóstico , Líquen Plano/patologia , Líquen Plano/terapiaRESUMO
AbstractBACKGROUND:Lichen planopilaris is a frequent presentation of primary cicatricial alopecia. Scalp distribution characterizes the main clinical presentations: classic lichen planopilaris, frontal fibrosing alopecia and Graham-Little Piccardi-Lassueur Syndrome (GLPLS).OBJECTIVE:Description of the clinical, dermoscopic and histopathological findings of Lichen planopilaris in public and private practices.METHOD:A retrospective observational study was performed by reviewing medical records of patients with lichen planopilaris.RESULTS:Eighty patients were included, 73 (91,25%) were female. Prototype II was seen in 53 (66,25%) patients. Classic lichen planopilaris was seen in 62,5% of the cases. Frontal fibrosing alopecia was seen in 31% of the patients and only one patient presented Graham-Little Piccardi-Lassueur Syndrome (GLPLS). Scalp lesions were scattered throughout the scalp in 47 (58,75%) of the patients, while 24 (30%) presented mainly central scalp lesions, 29 (36,25%) presented marginal lesions and only 4 (5%) patents had vertex lesions.CONCLUSIONS:Clinical presentation of Lichen planopilaris varies. To recognize the heterogeneity of the clinical appearance in lichen planopilaris is important for differential diagnosis.
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Feminino , Humanos , Masculino , Alopecia/epidemiologia , Líquen Plano/epidemiologia , Alopecia/patologia , Brasil/epidemiologia , Dermoscopia , Ceratose/epidemiologia , Ceratose/patologia , Líquen Plano/patologia , Prontuários Médicos , Estudos Retrospectivos , Couro Cabeludo/patologiaRESUMO
Las Dermatosis Liquenoides son un grupo de enfermedades frecuentes en Dermatología. La palabra liquen produce confusión a los dermatólogos, pues es utilizada indistintamente para definir un patrón histopatológico de infiltrado linfocítico en banda en la membrana basal, así como también un patrón clínico de pápulas violáceas aplanadas y brillantes. Considerando su frecuencia, es conveniente que los dermatólogos se encuentren bien familiarizados con estos conceptos en orden a realizar diagnósticos precisos y así otorgar tratamientos adecuados a estos pacientes.
Lichenoid dermatoses are a group of diseases frequently seen in dermatology. The word lichen tends to confuse dermatologists because this term describes a histopathological pattern characterized by a band-like lymphocytic infiltrate in the basal membrane, as well as a clinical pattern of flat, violet, shiny papules. Given the high number of patients suffering from this disorder, it is advisable for dermatologists to be well familiarized with these concepts in order to give an accurate diagnosis and suitable treatment.
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Líquen Plano/diagnóstico , Líquen Plano/terapia , Evolução Clínica , Diagnóstico Diferencial , Líquen Plano/epidemiologia , Líquen Plano/etiologia , Líquen Plano/fisiopatologiaRESUMO
El liquen plano afecta al 0,3 por ciento a 0,8 por ciento de la población general. La seroprevalencia para virus hepatitis C (VHC) en donantes de sangre en Chile es de 0,3 por ciento a 0,6 por ciento. Varios autores han comunicado una mayor prevalencia de la infección crónica por VHC en pacientes con LP, pero esta asociación es aún controversial. El objetivo de este estudio fue establecer si existe una asociación entre LP y la infección por VHC en nuestro pais. Pacientes y método. Se examinaron piel y mucosa de 59 pacientes portadores de VHC. Paralelamente, se estudió la serología para VHC (ELISA) en 19 pacientes con LP. Resultados. El grupo de pacientes con hepatitis C exhibió un alto número de patologías cutáneas y mucosas. Se confirmó un caso de LP en los 59 pacientes con VHC (1,7 por ciento). La serología para VHC fue positiva en un paciente con LP (5,3 por ciento). Conclusiones. La infección crónica por VHC se asocia a muchas patología cutáneas. Nuestros resultados no son concluyentes respecto a una asociación entre la infección crónica por VHC y el LP en nuestros pacientes
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Humanos , Masculino , Feminino , Hepatite C Crônica/complicações , Líquen Plano/complicações , Hepatite C Crônica/epidemiologia , Líquen Plano/epidemiologia , Dermatopatias/epidemiologiaRESUMO
Com o objetivo de estudar o comportamento clínico-epidemiológico e comparar os resultados obtidos com a literatura médica mundial, foi realizada uma análise retrospectiva de 160 casos de líquen plano, selecionado entre 201.723 pacientes portadores de dermatoses diversas, atendidos no ambulatório de Dermatologia do Hospital Universitário Antônio Pedro (HUAP). Niterói, Rio de Janeiro, entre 1973 e 1988 (16 anos). A amostra foi representada por 46 pacientes do sexo masculino (28,75//) e 114 do sexo feminino (71,25//), sendo 86 brancos(53,75//), 27 negros (16,87//) e 47 pardos (29,35//), com idades variando de quatro meses a 83 anos