Successful treatment of rare linear lichen planopilaris with Ixekizumab

Background: Lichen planopilaris (LPP) is a lymphocytic primary cicatricial alopecia characterized by perifollicular erythema, follicular hyperkeratosis and scaring, resulting in permanent hair loss. Current treatment modalities, both topical and systemic, fail to achieve satisfactory and consistent results. As therapies fail to halt the inflammatory process, patients with LPP may face long-term disfigurement and significant psychological burden. Purpose: To initiate an efficacious targeted therapy with good tolerability and low side effect profile that will allow hair regrowth and prevent the development to disfiguring alopecia. Materials and methods: Here, we report on a case of rare LPP in a linear distribution (LLPP) involving the scalp and forehead failing to achieve satisfactory results with continued hair loss with multiple previous treatments. Results: Complete hair regrowth was achieved 12 weeks after treatment with an anti-psoriatic, anti-interleukin (IL)-17A/F antibody (Taltz, Ixekizumab, Lilly). Patient continued to display sustained efficacy with no reported side effects until 12 months on treatment. Conclusions: The present case underlines the viability of Ixekizumab as a possible first-line, targeted therapy for LPP and its variants with sustained efficacy. Multicenter trials are warranted to confirm the benefit of Ixekizumab as a successful targeted biologic treatment option for LPP and LLPP.

Automated summary

Lichen planopilaris (LPP) is a lymphocytic primary cicatricial alopecia characterized by perifollicular erythema, follicular hyperkeratosis, and scarring that result in permanent hair loss. Current treatments fail to achieve satisfactory and consistent results, leading to long-term disfigurement and psychological burden for patients with LPP.