Lichen planopilaris treated by the peroxisome proliferator activated receptor-γ agonist pioglitazone: Lack of lasting improvement or cure in the majority of patients

Spring, Philipp; Spanou, Zoi; Viragh, Pierre A. de

doi:10.1016/j.jaad.2013.04.066

Cited by 36 publications

(27 citation statements)

References 4 publications

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“…Recent studies suggested that LPP was a lipid metabolic disorder, induced by the downregulation of the peroxisome proliferator-activated receptor-c. 21 However, the efficacy of pioglitazone as treatment for PCA is controversial. [22][23][24] Furthermore, we found no association with diabetes, which was seen in AGA and AA patients. 7,25,26 In the present study, tetracycline antibiotics were frequently prescribed as well as steroids.…”

Section: Discussioncontrasting

confidence: 64%

Primary cicatricial alopecia in a single‐race Asian population: A 10‐year nationwide population‐based study in South Korea

Yoon

Choi

2018

The Journal of Dermatology

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Primary cicatricial alopecia (PCA) is a dermatological challenge. Because no large-scale epidemiological study regarding PCA is available yet, we investigated the National Health Insurance Service-National Sample Cohort for patients diagnosed with PCA. The annual and overall rates of incidence and prevalence of PCA during the study period (2004-2013) were estimated. Distribution of PCA subtypes, disease co-occurrence rates and frequently prescribed medications were also evaluated. The overall incidence was 6.10 (95% confidence interval [CI], 5.62-6.60) per 100 000 person-years. The incidence rate was stable over time (risk ratio [RR] = 1.012, P = 0.201) and lower in female patients (RR = 0.718, P < 0.001). The overall prevalence was 20.93 (95% CI, 17.97-23.86) per 100 000 persons. The average duration of PCA was calculated as 3.23 years. Approximately 70% of the patients were below the age of 45 years. Folliculitis decalvans and dissecting cellulitis were the most common subtypes of PCA. Logistic regression analysis showed that PCA was significantly associated with thyroid disorders (adjusted odds ratio = 1.64, P < 0.001). Clobetasol was the most frequently prescribed topical agent. Corticosteroids were the most common oral agents used, followed by tetracycline antibiotics. Our study is the first large-scale study reporting the epidemiology of PCA. We found a preponderance of males and neutrophil-associated subtypes of PCA, and PCA was related to thyroid disorders.

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Section: Discussioncontrasting

confidence: 64%

Primary cicatricial alopecia in a single‐race Asian population: A 10‐year nationwide population‐based study in South Korea

Yoon

Choi

2018

The Journal of Dermatology

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“…One case report showed successful treatment of a patient with treatment‐resistant LPP using the PPAR‐γ agonist pioglitazone. In another case series, however, the findings suggested a limited role of PPAR‐γ in the pathogenesis of FFA, with only three out of 22 patients showing a cessation of disease activity (Spring, Spanou, & de Viragh, ).…”

Section: Discussionmentioning

confidence: 95%

Successful treatment of frontal fibrosing alopecia with alitretinoin

Lee

Hong

Lee

et al. 2019

Dermatologic Therapy

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Frontal fibrosing alopecia (FFA) is an inflammatory disorder characterized by scarring alopecia of the frontotemporal scalp, thinning or loss of facial hair, and facial papules. Prompt treatment is essential to prevent permanent hair loss. Although studies have reported the efficacy of oral retinoids (isotretinoin and acitretin) in FFA treatment, a therapeutic role for alitretinoin is known only for lichen planus and not for FFA. Herein, we report a case of FFA accompanied with lichen planus that responded well to treatment with alitretinoin.

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“…In recent years, a growing body of evidence has emanated that PPAR‐γ modulators impact on HF growth, cycling and protein production, namely keratin expression, and epithelial stem cell homeostasis, as well as mitochondrial activity/function (Table ) . Gene expression abnormalities related to PPAR‐γ signalling in patients with lichen planopilaris (LPP) and preliminary evidence from off‐label use of PPAR‐γ agonists like pioglitazone in selected patients with LPP or frontal fibrosing alopecia (FFA) also have suggested possible beneficial effects of PPAR‐γ stimulation in scarring alopecia, such as LPP. In the following, we shall explore this by zooming in on the role of PPAR‐γ signalling in epithelial HF stem cells and anagen hair matrix KCs.…”

Section: Overview: Ppar‐γ and The Human Pilosebaceous Unitmentioning

confidence: 99%

“…Still, response rates in some individuals reached 50%, which is promising, compared to the other currently available treatment options for LPP . However, scarring could not be reversed, and complete remission was rare . In addition, the treatment with oral pioglitazone induced adverse effects, including dizziness, nausea, calf pain or urticaria, which forced patients to suspend therapy .…”

Section: The Importance Of Ppar‐γ For the Bulge Stem Cells And Its Rementioning

confidence: 99%

PPAR‐γ signalling as a key mediator of human hair follicle physiology and pathology

Ramot

Bertolini

Boboljova

et al. 2019

Experimental Dermatology

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Peroxisome proliferator‐activated receptors (PPARs) are abundantly expressed in human skin, with PPAR‐γ being the most intensively investigated isoform. In various ex vivo and in vivo models, PPAR‐γ‐mediated signalling has recently surfaced as an essential element of hair follicle (HF) development, growth and stem cell biology. Moreover, the availability of novel, topically applicable PPAR‐γ modulators with a favourable toxicological profile has extended the range of potential applications in clinical dermatology. In this review, we synthesize where this field currently stands and sketch promising future research avenues, focussing on the role of PPAR‐γ‐mediated signalling in the biology and pathology of human scalp HFs, with special emphasis on scarring alopecias such as lichen planopilaris and frontal fibrosing alopecia as model human epithelial stem cell diseases. In particular, we discuss whether and how pharmacological modulation of PPAR‐γ signalling may be employed for the management of hair growth disorders, for example, in scarring alopecia (by reducing HF inflammation as well as by promoting the survival and suppressing pathological epithelial‐mesenchymal transition of keratin 15 + epithelial stem cells in the bulge) and in hirsutism/hypertrichosis (by promoting catagen development). Moreover, we explore the potential role of PPAR‐γ in androgenetic alopecia, HF energy metabolism and HF ageing, and consider clinical perspectives that emanate from the limited data available on this so far. As this field of translational human hair research is still in its infancy, many open questions exist, for which we briefly delineate selected experimental approaches that promise to generate instructive answers in the near future.

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Lichen planopilaris treated by the peroxisome proliferator activated receptor-γ agonist pioglitazone: Lack of lasting improvement or cure in the majority of patients

Cited by 36 publications

References 4 publications

Primary cicatricial alopecia in a single‐race Asian population: A 10‐year nationwide population‐based study in South Korea

Primary cicatricial alopecia in a single‐race Asian population: A 10‐year nationwide population‐based study in South Korea

Successful treatment of frontal fibrosing alopecia with alitretinoin

PPAR‐γ signalling as a key mediator of human hair follicle physiology and pathology

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