592 Characterization of lichen planopilaris in men: A retrospective analysis

Abstract

Lichen planopilaris (LPP) and subtype frontal fibrosing alopecia (FFA) are primary lymphocytic cicatricial alopecias distinguished by morphology and distribution. LPP affects Caucasian women from 25 to 70 years with a female to male ratio of 1.8:1. LPP is thought to have an autoimmune component and has significant association with thyroid disease. Due to low male prevalence, a paucity of literature demonstrates the characterization of LPP/FFA in men. This study evaluates the clinical characteristics of a male cohort with LPP and/or FFA at a single tertiary hair center. A retrospective review of male patients diagnosed with LPP and/or FFA at Massachusetts General Hospital Hair Loss Clinic from 2017 to 2020 was performed. We identified 24 men diagnosed with LPP, FFA, or LPP/FFA overlap. The mean age at presentation was 45.5 years (range 15-74 years). 70.8% were Caucasian, 12.5% Asian, 8.3% Black, 8.3% unknown/unreported. Eyebrows (20.8%), arms/legs (16.7%), and beard (16.7%) were the most commonly reported areas of non-scalp involvement. 62.5% reported one or more scalp symptoms or signs including pruritus, burning, tenderness/pain, flaking or redness. 50% reported 1 or more first degree relatives with hair loss and of those, 8.3% had similar hair loss type. Two patients reported a family history of 1 or more autoimmune conditions with 1 report of thyroid disease. No patients reported a personal history of thyroid disease. Most commonly reported treatments tried for hair loss prior to diagnosis included topical minoxidil (25%) and topical clobetasol (16.7%). 20.8% of patients reported regular use of SPF year-round and 12.5% regularly colored their hair. Our study demonstrates the unique characterization of LPP/FFA in men. Most men reported scalp symptoms and 16.7% had beard involvement. Most men reported no history of thyroid disease. Further studies are warranted to characterize the LPP/FFA male population.