Comorbidities in Patients with Lichen Planopilaris: A Case-Control Study

Nasimi, Maryam; Garmaroudi, Gholamreza; Ghiasi, Maryam; Lajevardi, Vahideh; Fooladi, Zahra; Tabatabaei, Mahgol Sadat Hassan Zadeh; Ansari, Mahshid Sadat

doi:10.1159/000522371

Cited by 5 publications

(5 citation statements)

References 23 publications

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“…69,70 In contrast to the well-known relationship between hyperlipidemia and LP, the reported association with LPP has been inconsistent, with some studies actually finding a significantly decreased risk of hyperlipidemia compared to controls. 60,[71][72][73] A 2020 meta-analysis of almost 1000 patients found no statistically significant differences in rates of hyperlipidemia in LPP patients versus healthy controls (OR: 0.77; 95% CI: 0.54-1.08; p = 0.13). 74 Similarly, consistent associations of LPP with hypertension, diabetes, and overall heart disease have not been found.…”

Section: Scarring Alopecias Lichen Planopilaris (Lpp)mentioning

confidence: 99%

“…A 2020 meta‐analysis of almost 1000 patients found no statistically significant differences in rates of hyperlipidemia in LPP patients versus healthy controls (OR: 0.77; 95% CI: 0.54–1.08; p = 0.13) 74 . Similarly, consistent associations of LPP with hypertension, diabetes, and overall heart disease have not been found 63,72,73 . In a study of 87 patients with LPP, Fertig et al reported statistically significant negative associations between LPP and diabetes (OR: 0.066; 95% CI: 0.011–0.398), hypertension (OR: 0.312; 95% CI: 0.124–0.786) and heart disease (OR: 0.302; 95% CI: 0.100–0.917) 75 .…”

Section: Scarring Alopeciasmentioning

confidence: 99%

“…74 Similarly, consistent associations of LPP with hypertension, diabetes, and overall heart disease have not been found. 63,72,73 In a study of 87 patients with LPP, Fertig et al reported statistically significant negative associations between LPP and diabetes (OR: 0.066; 95% CI: 0.011-0.398), hypertension (OR: 0.312; 95% CI: 0.124-0.786) and heart disease (OR: 0.302; 95% CI: 0.100-0.917). 75 However, a larger, more recent study that included over 3000 patients with LPP from multiple tertiary academic centers found positive associations between LPP and hypertension (OR: 3.93; 95% CI: 3.67-4.22), hyperlipidemia (OR: 6.43; 95% CI: 6.00-6.89), DM (OR: 2.61; 95% CI: 2.38-2.86) and CAD (OR: 1.65; 95% CI: 1.45-1.88).…”

Section: Scarring Alopecias Lichen Planopilaris (Lpp)mentioning

confidence: 99%

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Cardiovascular risk in patients with scarring and nonscarring alopecias: Assessing the current state of evidence

Sally,

Robinson,

Orlow

et al. 2023

JEADV Clinical Practice

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Alopecia is traditionally classified into scarring and nonscarring subtypes, with etiopathologies ranging from androgen‐mediated to immuno‐inflammatory. Over 50% of men and almost 50% of women will experience some form of hair loss in their lifetime. Given this prevalence and the psychosocial significance of hair, understanding the pathophysiology and comorbidities of different types of hair loss is imperative. Other proinflammatory dermatologic disorders, such as psoriasis, are recognised to have systemic manifestations including an increased risk of cardiovascular (CV) disease, and are now considered CV risk‐enhancing conditions. With increased recognition of the importance of systemic inflammation in promoting atherosclerosis, high prevalence, and improved treatment strategies, there is increased interest in establishing whether a similar association between alopecia and cardiovascular disease (CVD) exists. In this manuscript, we aim to review the current literature regarding CV risk in androgenic alopecia (AGA) and alopecia areata (AA). Additionally, we review the literature for cicatricial alopecias and highlight the need for more research into their potential associations with CV risk. Evidence from the identified AGA publications suggests an association of AGA with CV risk factors including hypertension, dyslipidemia, and insulin resistance, as well as with coronary artery disease. For AA, most of the identified studies found an association between AA and CV risk, though the relationships were not always statistically significant. Research on cicatricial alopecias and CV risk is limited and often contradictory. There is great need for more studies regarding the association between various types of alopecia and the development of CVD, and potential mechanisms. Particularly needed are more studies of cicatricial alopecias and potential associated CV risk. While some literature suggests that patients with alopecia have an increased risk of CVD, the lack of concrete evidence represents a notable gap in our current understanding.

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Section: Scarring Alopecias Lichen Planopilaris (Lpp)mentioning

confidence: 99%

Section: Scarring Alopeciasmentioning

confidence: 99%

Section: Scarring Alopecias Lichen Planopilaris (Lpp)mentioning

confidence: 99%

See 1 more Smart Citation

Cardiovascular risk in patients with scarring and nonscarring alopecias: Assessing the current state of evidence

Sally,

Robinson,

Orlow

et al. 2023

JEADV Clinical Practice

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“…Thyroid and metabolic disorders are reported to be associated with LPP. [6][7][8][9] However, some studies have shown that LPP is not associated with thyroid and metabolic disorders. [10][11][12][13] These inconsistent findings are largely attributable to the small number of patients included in these previous studies owing to the rarity of PCA.…”

Section: Introductionmentioning

confidence: 99%

“…Most of these studies were focused on lichen planopilaris (LPP) or frontal fibrosing alopecia, but a few were focused on other PCA subtypes, such as pseudopelade of Brocq (PPB), folliculitis decalvans (FD), and dissecting cellulitis (DC). Thyroid and metabolic disorders are reported to be associated with LPP 6–9 . However, some studies have shown that LPP is not associated with thyroid and metabolic disorders 10–13 .…”

Section: Introductionmentioning

confidence: 99%

Endocrine and metabolic comorbidities in primary cicatricial alopecia: A nationwide population‐based study

Yu,

Kim,

Cho

et al. 2023

The Journal of Dermatology

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Primary cicatricial alopecia (PCA) is a rare, scarring, hair loss disorder. Due to its low incidence, little is known about endocrine and metabolic comorbidities in patients with PCA. Thus, we aimed to investigate the association between PCA and endocrine and metabolic disorders. This nationwide, population‐based, cross‐sectional study included patients diagnosed with PCA or non‐cicatricial alopecia (NCA) and normal individuals without history of alopecia registered in the Korean National Health Insurance Service database between January 1, 2011, and December 31, 2020. We calculated the odds ratios of endocrine and metabolic comorbidities of patients with PCA compared to all patients or age‐ and sex‐matched patients with NCA or normal individuals using multivariable logistic regression models. A total of 3 021 483 individuals (mean age [SD], 38.7 [15.0] years, 1 607 380 [53.2%] men), including 11 956 patients with PCA, 601 852 patients with NCA, and 2 407 675 normal participants, were identified. Patients with PCA had an increased risk for dyslipidemia (adjusted odds ratio [aOR] 1.14, 95% confidence interval [CI] 1.06–1.24), diabetes (aOR 1.38, 95% CI 1.24–1.53), and hypertension (aOR 1.10, 95% CI 1.02–1.19) compared to matched patients with NCA. Regarding PCA subtypes, lichen planopilaris/frontal fibrosing alopecia was positively associated with hypothyroidism (aOR 2.03, 95% CI 1.44–2.86) compared to NCA. Folliculitis decalvans and dissecting cellulitis were positively associated with dyslipidemia (aOR 1.16, 95% CI 1.05–1.28 and aOR 1.16, 95% CI 1.04–1.29, respectively), diabetes (aOR 1.38, 95% CI 1.20–1.58 and aOR 1.52, 95% CI 1.32–1.74, respectively), and hypertension (aOR 1.10, 95% CI 1.00–1.20 and aOR 1.14, 95% CI 1.02–1.27, respectively). Similar trends were observed when each PCA subgroup was compared with the normal control group. This study demonstrates that patients with PCA are more likely to have endocrine and metabolic comorbidities than patients without PCA. Further research on these comorbidities may improve the understanding of PCA.

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Association of lichen planopilaris with cardiovascular and metabolic disorders: a systematic review and meta-analysis

Chuang,

Huang,

Chang

2024

Clinical and Experimental Dermatology

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Background Lichen planopilaris (LPP) is among the most common types of immune-mediated scarring alopecia. Observational studies have reported conflicting findings regarding the association of LPP with different comorbidities. Objectives We conducted a systematic review and meta-analysis to elucidate the association between LPP and different cardiovascular and metabolic disorders. Methods We systematically searched four electronic databases—PubMed, Web of Science, Embase, and Cochrane Library—for relevant studies published from their inception to August 1, 2024. A random-effects model was used to perform a pooled analysis and calculate odds ratios or incidence rate ratios with 95% confidence intervals. Results The meta-analysis included 10 case–controls studies involving 7,516 patients with LPP and 64,719,097 controls. The results demonstrated no significant association between LPP and hypertension, diabetes mellitus, or hyperlipidemia. The pooled analysis results also revealed that patients with LPP did not have significantly higher risks of obesity and heart failure than did controls. All pooled analyses revealed high levels of heterogeneity across the studies, but no significant publication bias was detected. Conclusions LPP is not significantly associated with most cardiovascular and metabolic disorders, including hypertension, diabetes mellitus, hyperlipidemia, obesity, and heart failure.

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Comorbidities in Patients with Lichen Planopilaris: A Case-Control Study

Cited by 5 publications

References 23 publications

Cardiovascular risk in patients with scarring and nonscarring alopecias: Assessing the current state of evidence

Cardiovascular risk in patients with scarring and nonscarring alopecias: Assessing the current state of evidence

Endocrine and metabolic comorbidities in primary cicatricial alopecia: A nationwide population‐based study

Association of lichen planopilaris with cardiovascular and metabolic disorders: a systematic review and meta-analysis

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