Dendritic cells as predictive markers of responsiveness to hydroxychloroquine treatment in primary cicatricial alopecia patients

Abstract

Primary cicatricial alopecia (PCA) encompasses a diverse group of inflammatory diseases characterized by the irreversible replacement of hair follicle structures by fibrous tissue. Although the pathogenesis of PCA remains not fully understood, the key to its understanding might be the location of dendritic cells (DCs) inflammatory infiltrate. One of the systemic therapy of choice in PCA patients is hydroxychloroquine (HCQ). We hypothesized that DCs are implicated in PCA pathogenesis and that they might constitute the biological target of HCQ treatment. For these reasons, we investigated whether DCs could affect the antimalarial responsiveness, and if DCs might be used as predictive factor of responsiveness to HCQ. In this retrospective cohort study, 65 patients diagnosed with PCA were grouped accordingly to their response to HCQ therapy. Skin biopsies had been taken before the treatment was started. Cell count was performed on immunohistochemistry by using characteristic monoclonal antibodies to specific subpopulations of DCs. In almost every second

Use of Hydroxychloroquine in Hair Disorders

“…They reported that 79.3% of patients had disease stabilization with combination therapy [29]. A few other articles we encountered demonstrated either a majority of patients responding to HCQ treatment or FFA stabilization [2, 17, 20, 30–33]. Lastly, a study that exclusively examined men with FFA also found halted disease progression with HCQ [34].…”

“…Cases of lupus panniculitis have shown positive responses and complete resolution in some patients with HCQ treatment [48][49][50][51][52][53][54][55][56][57]. A retrospective cohort study found 66.7% of discoid lupus erythematosus patients responding to HCQ [20]. Two reports of discoid lupus erythematosus patients taking HCQ also exhibited hair regrowth [58,59].…”

“…While the previously mentioned studies had success with HCQ, there have also been reports of mixed or suboptimal results of HCQ for LPP. Two separate studies found that roughly 20% of their LPP sample population responded to HCQ therapy, indicating the treatment did not work for a significant portion of the other patients [20, 21]. Limited success or no clinical improvement with HCQ has also been noted in some cases in the literature.…”