International Journal of Trichology International Journal of Trichology
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ORIGINAL ARTICLE
Year : 2020  |  Volume : 12  |  Issue : 5  |  Page : 220-226

Valchlor® in the treatment of lichen planopilaris and frontal fibrosing alopecia: A single arm, open-label, exploratory study


1 Department of Dermatology, Mayo Clinic, Jacksonville, Florida, USA
2 Division of Biomedical Statistics and Informatics, Mayo Clinic, Jacksonville, Florida, USA

Correspondence Address:
Jason C Sluzevich
M.D. Department of Dermatology, Mayo Clinic, 4500 San Pablo Road, Jacksonville 32224, Florida
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijt.ijt_16_20

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Background: Lichen Planopilaris (LPP) is a lymphocyte-mediated scarring alopecia that frequently is treatment resistance to both topical and systemic therapies. Aims and Objectives: The object of this pilot study was to assess the effectiveness of topical mechlorethamine 0.016% gel (Valchlor®) in decreasing disease activity in LPP and the related clinical variant frontal fibrosing alopecia (FAA). Methods: Twelve patients with biopsy-proven LPP/FAA who failed prior topical or systemic therapy with active disease were included. Participants applied mechlorethamine 0.016% gel to involved areas daily for 24 weeks. Outcome measures included LPP Activity Index (LPPAI) score, Physician Global Assessment (PGA) score, Dermatology Quality of Life Index (DQLI) score, and phototrichograms assessing follicular counts before and after six months of therapy. Results: LPP Activity Index (LPPAI) before and after treatment was significantly different (5.0 before treatment, 2.0 after treatment; p value=0.006). Mean follicular density and follicular units were unchanged during the treatment period. Conclusion: Treatment with mechlorethamine 0.016% gel for 24 weeks resulted in statistically significant improvement of LLP/FFA with no change in phototrichogram parameters. Treatment duration was limited by high rate of contact dermatitis. Further investigation to optimize dosing frequency and to assess the role of combination topical therapy is needed.


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