Successful treatment of rare linear lichen planopilaris with Ixekizumab

Abstract

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.

Keywords:

• Lichen planopilaris
• cicatricial alopecia
• fibrosing alopecia
• targeted therapy
• anti-interleukin-17
• Ixekizumab

Acknowledgements

Open Access funding provided by the Qatar National Library. Supported by MRC, Hamad Medical Corporation, Doha, Qatar.

Consent form

The patient in this manuscript has given written informed consent to publication of their case details.

Author contributions

MS was involved in the conceptualization, clinical management and diagnosis of the patient as well as supervision and manuscript writing. HA drafted the original manuscript, subsequent review and editing as well as clinical management and follow up. MP reported the result of the histopathological evaluation.

Disclosure statement

MS has been a consultant, performed consultancy services or received research grants from Galderma, Novartis, Lilly, Pfizer, Merck, Sanofi-Aventis, Regeneron, Maruho, Toray, ZymoGenetics, L’Oreal, Leo, Avon, Baiersdorf. HA and MP do not declare any conflicts of interest.

Data availability statement

Data available upon request.

Additional information

Funding

Open Access funding provided by Qatar National Library.