{"id":16633,"date":"2020-04-29T02:18:22","date_gmt":"2020-04-29T05:18:22","guid":{"rendered":"https:\/\/doctorhoogstra.com\/es\/wiki\/liquen-planopilaris\/"},"modified":"2020-05-03T15:38:40","modified_gmt":"2020-05-03T18:38:40","slug":"lichen-planopilaris-2","status":"publish","type":"wiki","link":"https:\/\/doctorhoogstra.com\/en\/wiki\/liquen-planopilaris\/","title":{"rendered":"Lichen planus"},"content":{"rendered":"<p><\/p><div id=\"ez-toc-container\" class=\"ez-toc-v2_0_88 counter-hierarchy ez-toc-counter ez-toc-grey ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">Contents<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewbox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewbox=\"0 0 24 24\" version=\"1.2\" baseprofile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 eztoc-toggle-hide-by-default' ><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/liquen-planopilaris\/#%C2%BFQue-es-el-liquen-planopilaris\" >What is lichen planopilaris?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/liquen-planopilaris\/#%C2%BFQuien-contrae-liquen-planopilaris-y-por-que\" >Who gets lichen planopilaris and why?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/liquen-planopilaris\/#Caracteristicas-clinicas-del-liquen-planopilaris\" >Clinical characteristics of lichen planopilaris<\/a><ul class='ez-toc-list-level-5' ><li class='ez-toc-heading-level-5'><ul class='ez-toc-list-level-5' ><li class='ez-toc-heading-level-5'><ul class='ez-toc-list-level-5' ><li class='ez-toc-heading-level-5'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/liquen-planopilaris\/#Liquen-planopilaris\" >Lichen planus<\/a><\/li><\/ul><\/li><\/ul><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/liquen-planopilaris\/#%C2%BFComo-se-diagnostica-el-liquen-planopilaris\" >How is lichen planopilaris diagnosed?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/liquen-planopilaris\/#Tratamiento-de-liquen-planopilaris\" >Lichen Planopilaris Treatment<\/a><\/li><\/ul><\/nav><\/div>\n\n<section class=\"textBlock\">\n<h2><span class=\"ez-toc-section\" id=\"%C2%BFQue-es-el-liquen-planopilaris\"><\/span>What is lichen planopilaris?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Lichen planopilaris is a rare <span class=\"term\" data-term-id=\"490\">inflammatory<\/span> condition resulting in patches <span class=\"term\" data-term-id=\"1759\">progressive<\/span> permanent <span class=\"term\" data-term-id=\"122\">hair<\/span> loss mainly on the scalp. Three forms are recognized:<\/p>\n<ul>\n<li>Lichen planopilaris classical, also known as <span class=\"term\" data-term-id=\"107\">follicular<\/span> lichen planus\n<\/li>\n<li>Frontal <span class=\"term\" data-term-id=\"1756\">fibrosing<\/span> <span class=\"term\" data-term-id=\"824\">alopecia<\/span><\/li>\n<li>Graham little <span class=\"term\" data-term-id=\"350\">syndrome<\/span><\/li>\n<\/ul>\n<h2><span class=\"ez-toc-section\" id=\"%C2%BFQuien-contrae-liquen-planopilaris-y-por-que\"><\/span>Who gets lichen planopilaris and why?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Lichen planopilaris generally affects young adult women, although the age range is wide and it also affects men. It commonly develops in association with lichen planus that affects the skin, <span class=\"term\" data-term-id=\"189\">mucous membrane<\/span> and <span class=\"term\" data-term-id=\"193\">nail<\/span>.<\/p>\n<p>The cause of lichen planopilaris is unknown.<\/p>\n<p>Although lichen planopilaris is rare, it is one of the common causes of scarring of scalp hair loss.<\/p>\n<div id=\"square-placement-country-holder\" class=\"country-dependent advert\">\n<div class=\"box-placement square-placement\">\n<div class=\"advert__frame\">\n<div id=\"dermnet-dermnet-mobbox\">\n<\/div><\/div><\/div><\/div>\n<h2><span class=\"ez-toc-section\" id=\"Caracteristicas-clinicas-del-liquen-planopilaris\"><\/span>Clinical characteristics of lichen planopilaris<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Lichen planopilaris usually presents as smooth white patches of hair loss on the scalp. Hairless <span class=\"term\" data-term-id=\"1300\">follicle<\/span> Openings can be seen in areas of hair loss. At the edges of these patches, there may be <span class=\"term\" data-term-id=\"320\">scale<\/span> and redness around each hair follicle. The hairs can be easily pulled out. It is multifocal and small areas can merge to form larger irregular areas.<\/p>\n<p>Common sites of involvement are the sides, front, and lower back of the scalp.<\/p>\n<p>Symptoms are often absent, but can include:<\/p>\n<ul>\n<li>Chop<\/li>\n<li>Pain<\/li>\n<li>Sensitivity<\/li>\n<li>Discomfort<\/li>\n<li>Burning<\/li>\n<\/ul>\n<p>Lichen planopilaris is usually slowly progressive.<\/p>\n<p><span class=\"term\" data-term-id=\"1769\">Diffuse<\/span> Hair loss is rare.<\/p>\n<section class=\"textBlock imageLinkBlockTitle\">\n<h5 class=\"colour--primary\"><span class=\"ez-toc-section\" id=\"Liquen-planopilaris\"><\/span>Lichen planus<span class=\"ez-toc-section-end\"><\/span><\/h5>\n<\/section>\n<section class=\"imageLinkBlock\">\n<div class=\"flex\">\n<div class=\"imageLinkBlock__item__image\">\n<p>                        <img alt='lichen-planopilaris02__protectwyjqcm90zwn0il0_focusfillwzi5ncwymjisingildfd-8925020-3052616' src='https:\/\/doctorhoogstra.com\/wp-content\/uploads\/2020\/04\/lichen-planopilaris02__ProtectWyJQcm90ZWN0Il0_FocusFillWzI5NCwyMjIsIngiLDFd-8925020.jpg'>\n<\/div>\n<p class=\"p-small\">Lichen planus<\/p>\n<div class=\"imageLinkBlock__item__image\">\n<p>                        <img alt='lichen-planopilaris01__protectwyjqcm90zwn0il0_focusfillwzi5ncwymjisingildfd-4462075-6092729' src='https:\/\/doctorhoogstra.com\/wp-content\/uploads\/2020\/04\/lichen-planopilaris01__ProtectWyJQcm90ZWN0Il0_FocusFillWzI5NCwyMjIsIngiLDFd-4462075.jpg'>\n<\/div>\n<p class=\"p-small\">Lichen planus<\/p>\n<div class=\"imageLinkBlock__item__image\">\n<p>                        <img alt='lichen-planopilaris03__protectwyjqcm90zwn0il0_focusfillwzi5ncwymjisingilde5xq-2056901-3406268' src='https:\/\/doctorhoogstra.com\/wp-content\/uploads\/2020\/04\/lichen-planopilaris03__ProtectWyJQcm90ZWN0Il0_FocusFillWzI5NCwyMjIsIngiLDE5XQ-2056901.jpg'>\n<\/div>\n<p class=\"p-small\">Lichen planus<\/p>\n<\/p><\/div>\n<\/section>\n<div class=\"clearfix imageLinkBlock\"><\/div>\n<h2><span class=\"ez-toc-section\" id=\"%C2%BFComo-se-diagnostica-el-liquen-planopilaris\"><\/span>How is lichen planopilaris diagnosed?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Lichen planopilaris is suspected on clinical presentation and careful examination of the mouth, nails, and skin for evidence of lichen planus elsewhere.<\/p>\n<p>Trichoscopy reveals absence <span class=\"term\" data-term-id=\"1301\">follicles<\/span>tubular, white dots <span class=\"term\" data-term-id=\"316\">peripheral<\/span> scale and peripollicular <span class=\"term\" data-term-id=\"90\">erythema<\/span>.<\/p>\n<p>The diagnosis can be confirmed on the scalp. <span class=\"term\" data-term-id=\"24\">biopsy<\/span> That includes surrounding red hair and scales on the edge of an area of hair loss. Lichen planopilaris is an example of <span class=\"term\" data-term-id=\"949\">primary<\/span> <span class=\"term\" data-term-id=\"422\">lymphocytic<\/span> folliculitis<\/p>\n<p>However, it is not always possible to make a biopsy diagnosis. Biopsy of an already marked area of hair loss is not helpful. Where there is only hair loss with patchy scars and no evidence of <span class=\"term\" data-term-id=\"148\">inflammation<\/span> The diagnosis may not be confirmed.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"Tratamiento-de-liquen-planopilaris\"><\/span>Lichen Planopilaris Treatment<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Treatment should be sought and provided early as no treatment recovers hairs that have been lost and replaced by scars. The goal of treatment is to slow the progression of the disease and relieve symptoms. Hair loss can continue, albeit at a slower rate.<\/p>\n<p><span class=\"term\" data-term-id=\"1413\">Anti-inflammatory<\/span> Treatment options include:<\/p>\n<ul>\n<li>Corticosteroids - potent <span class=\"term\" data-term-id=\"1330\">current<\/span>oral intralesional\n<\/li>\n<li>Topical tacrolimus\n<\/li>\n<li>Hydroxycoquine<\/li>\n<li>\n<p>Tetracycline, for example doxycycline<\/li>\n<li>Acitretin<\/li>\n<li>Methotrexate<\/li>\n<li>Cyclosporine<\/li>\n<li>Mycophenolate mofetil<\/li>\n<li>Pioglitazone (an oral PPAR-\u03b3 agonist)<\/li>\n<\/ul>\n<p>Response to treatment is variable and some published studies contradict others in terms of <span class=\"term\" data-term-id=\"914\">effectiveness<\/span>. The best that patients can hope for is to halt the progression of hair loss and minimize scalp discomfort.<\/p>\n<p>Mirmirani et al suggested a management protocol in 2003:<\/p>\n<ul>\n<li>Make a diagnosis of lichen planopilaris clinically and with a scalp biopsy.<\/li>\n<li>The severity of symptoms, the degree of hair loss, and the presence of disease activity are documented at each visit, approximately every 3 months.<\/li>\n<li>Oral hydroxychloroquine (usually 200 mg twice daily) is started after appropriate laboratory tests and eye examination if the patient has symptoms, has progressive hair loss, or signs of active disease.<\/li>\n<li>Strong topical intralesional corticosteroids can also be used.<\/li>\n<li>After 2-4 months, hydroxychloroquine is switched to cyclosporine (3-5 mg \/ kg \/ day) if symptoms continue, the degree of hair loss progresses, or there are clinical signs of disease activity. Cyclosporine is used according to the Consensus Guidelines for Cyclosporine.<\/li>\n<\/ul>\n<p>Since 2009, there have been several reports on the use of the antidiabetic agent pioglitazone (off-label) for the treatment of lichen planopilaris. Its effectiveness has varied; Up to 50-70% of patients have reduced symptoms, inflammation, and disease progression. Side effects include ankle swelling and weight gain. Adalimumab, a <span class=\"term\" data-term-id=\"289\">tumor<\/span> <span class=\"term\" data-term-id=\"403\">necrosis<\/span> Factor alpha (TNF\u03b1) inhibitor has also been reported to be effective in some patients.<\/p>\n<p>Camouflage with careful styling and hair coloring. Hairpieces may be required for areas of permanent hair loss.<\/p>\n<p>Surgery such as scalp and hair reduction. <span class=\"term\" data-term-id=\"1793\">transplant<\/span> It has been used for end-stage disease with large areas of scarring, but it is not always successful.<\/p>\n<\/section>","protected":false},"excerpt":{"rendered":"<p>\u00bfQu\u00e9 es el liquen planopilaris? El liquen planopilaris es un raro inflamatorio condici\u00f3n que resulta en parches progresivo permanente cabello p\u00e9rdida principalmente en el cuero cabelludo. Se reconocen tres formas:&#8230;<\/p>","protected":false},"author":8,"featured_media":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","format":"standard","meta":{"footnotes":""},"categories":[204],"tags":[],"class_list":["post-16633","wiki","type-wiki","status-publish","format-standard","category-glosario-definiciones"],"_links":{"self":[{"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/wiki\/16633","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/wiki"}],"about":[{"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/types\/wiki"}],"author":[{"embeddable":true,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/users\/8"}],"replies":[{"embeddable":true,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/comments?post=16633"}],"version-history":[{"count":0,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/wiki\/16633\/revisions"}],"wp:attachment":[{"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/media?parent=16633"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/categories?post=16633"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/tags?post=16633"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}