Authors of a brand new research got down to examine whether or not sufferers with LPP and FFA had related contact allergens and in that case whether or not avoiding these allergens may enhance their scalp illness. They performed a retrospective research involving 12 sufferers with clinically and biopsy confirmed LPP or FFA and in contrast knowledge to 30 age-matched sufferers with spongiotic dermatitis/eczematous dermatitis involving the scalp however with out hair illness. All sufferers had patch testing carried out from June 17, 2020, to February 1, 2022.
Outcomes
The research concerned a assessment of 9 sufferers with LPP and three with FFA. There have been 30 sufferers with scalp dermatitis.
All 12 sufferers (100%) with LPP or FFA had an allergen recognized when patch testing was carried out. In all 12 sufferers this allergen was felt to be clinically related. In sufferers with scalp dermatitis, 63 % of sufferers had a clinically related allergen. The distinction between these two teams was felt to be statistically important. Propolis was probably the most prevalent clinically related allergen in each the scarring alopecia and scalp dermatitis teams. A optimistic patch check occurred in 50% of these with scarring alopecia and 20 % of these with scalp dermatitis (20%). Different optimistic allergens included Perfume combine in 2 sufferers (16 %) Methylisothiazolinone in 1 affected person (8%) and Iodopropynyl butylcarbamate in 1 affected person (8%).
Does allergen avoidance assist?
Comply with-up knowledge have been obtainable for 9 of the 12 sufferers with scarring alopecia (75%). The entire 9 sufferers mentioned they adhered to avoiding allergens. 6 of 9 (67%) confirmed enchancment at 6 months. 4 had decreased follicular redness or scaling, 2 had improved scalp ache or itch, 2 had steady or improved hair density, and 1 had decreased hair shedding. The authors level out that a few of these 6 sufferers had modifications of their remedy plan too so this might need accounted for the advance. Nonetheless, there have been 2 sufferers who confirmed enchancment of their scarring alopecia with allergen avoidance alone.
Conclusion
That is one other research of the potential position of allergens in LPP and FFA. It’s the first research to incorporate an age matched comparative group utilizing equivalent allergens. The research provides to a rising physique of knowledge that means that some sufferers with LPP and FFA simply might need an related contact allergen as a set off for his or her situation. The precise position these allergens play just isn’t clear.
The research is small which limits the generalizability of the conclusions. However there’s sign right here that fascinated about allergens is related to FFA and LPP.
Though this research advised 100 % of LPP and FFA sufferers had related allergens, not 100 % of my sufferers have related allergens. What’s the proportion if really there’s an elevated proportion? We don’t know that reply but.
We regularly take into consideration patch testing sufferers who’ve scalp points PLUS a number of of the next : rashes ont the face, ears, neck, chest and eyelids. These are what I name the “FENCE” indicators. The truth is that many sufferers with LPP and FFA who’ve related allergens don’t have any of the FENCE indicators. Ought to we patch check all sufferers with LPP and FFA? Who is aware of. It’s doubtless you’ll discover allergens however are they related? that’s actually robust. Avoiding allergens with hypoallergenic shampoos and beauty merchandise might be affordable and I usually suggest hypoallergenic shampoos to my sufferers with LPP and FFA.
What’s propolis anyhow?
Propolis is a substance derived from beeswax and in addition poplar and conifer bushes. It’s utilized in many merchandise together with cosmetics, ointments, cough syrups, hair merchandise. Lipsticks, facial lotions, mouthwashes, toothpastes, gum, nutritional vitamins and honey, varnish used for violins. In keeping with knowledge from the NACDRG about 1.6 to six% of the inhabitants has a optimistic patch check to propolis. Charges of true propolis allergy are felt to be rising world wide.
REFERENCES
Shtaynberger B et al. The Prevalence of Sort IV Hypersensitivity in Sufferers With Lichen Planopilaris and Frontal Fibrosing Alopecia. Dermatitis. 2022 Oct 17.
