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Comparison of Systemic Mycophenolate Mofetil with Topical Clobetasol in Lichen Planopilaris: A Parallel-Group, Assessor- and Analyst-Blinded, Randomized Controlled Trial

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Abstract

Introduction

Lichen planopilaris (LPP) is the most common cause of inflammatory immune-mediated cicatricial alopecia. If not diagnosed and treated properly, it may lead to irreversible hair loss with a devastating impact on quality of life. However, treatment can be a challenge. In an area lacking these sorts of studies, we conducted a randomized controlled trial (RCT) to study the tolerability and therapeutic effects of topical clobetasol versus systemic mycophenolate mofetil (MMF).

Methods

A randomized, assessor- and analyst-blinded controlled trial was conducted in 60 patients with LPP in Razi Dermatology Hospital, Tehran, Iran, between February and December 2013. Patients were treated with clobetasol lotion 0.05 % applied at night or oral MMF 2 g/day and were followed for 6 months. The Lichen Planopilaris Activity Index (LPPAI) was the primary measure of response to treatment.

Results

Systemic MMF and topical clobetasol were equally effective in reducing the LPPAI over 6 months of treatment. Treatment tolerability was excellent in both groups and no serious irreversible adverse effects were detected. Satisfaction with treatment rose in the MMF group over time; however, it declined in the clobetasol group.

Conclusion

Given the similar efficacy profiles, topical clobetasol seems to be a more suitable and reasonable choice for treatment of LPP than MMF.

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Acknowledgments

The authors are indebted to Dr. Alireza Firooz, Professor of Dermatology, Director of the Clinical Trial Center, Deputy Director of the Center for Research and Training in Skin Diseases and Leprosy, Tehran University of Medical Sciences (TUMS), Dr. Hamed Hosseini, MD, MPH, PhDc, School of Public Health, TUMS, and Dr. Mohammadi, PhD, epidemiologist at TUMS.

Funding

The funding for this study was provided by the Vice Chancellor of Research of the Tehran University of Medical Sciences (TUMS).

Conflicts of interest

Vahide Lajevardi, Seyedeh Zahra Ghodsi, Azadeh Goodarzi, Pardis Hejazi, Arghavan Azizpour, and Sara Beygi have no conflicts of interest to disclose.

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Authors and Affiliations

  1. Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences (TUMS), Tehran, Iran

    Vahide Lajevardi, Seyedeh Zahra Ghodsi, Azadeh Goodarzi, Pardis Hejazi, Arghavan Azizpour & Sara Beygi

  2. National Elite Foundation, Tehran, Iran

    Sara Beygi

Authors
  1. Vahide Lajevardi
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  2. Seyedeh Zahra Ghodsi
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  3. Azadeh Goodarzi
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  4. Pardis Hejazi
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  5. Arghavan Azizpour
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  6. Sara Beygi
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Corresponding author

Correspondence to Azadeh Goodarzi.

Additional information

Clinical trial registration number: IRCT2012102111195N1.

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Lajevardi, V., Ghodsi, S.Z., Goodarzi, A. et al. Comparison of Systemic Mycophenolate Mofetil with Topical Clobetasol in Lichen Planopilaris: A Parallel-Group, Assessor- and Analyst-Blinded, Randomized Controlled Trial. Am J Clin Dermatol 16, 303–311 (2015). https://doi.org/10.1007/s40257-015-0122-z

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