The efficacy of antimalarial drugs in the therapy of selected forms of cicatricial alopecia

Introduction
Frontal fibrosing alopecia (FFA) is primary lymphocytic cicatricial alopecia with a clinically characteristic progressive recession of the frontotemporal hairline, perifollicular erythema, as well as symptoms of itching and burning. It occurs mainly in postmenopausal women. FFA is considered as a subtype of lichen planopilaris (LPP). The treatment of those diseases is presently empirical.

Aim
To define the efficacy of treating FFA and LPP with hydroxychloroquine.

Material and methods
We performed a retrospective analysis of 95 women, including 35 with FFA and 60 with LPP. We collected the relevant demographic and clinical data. The response to treatment with hydroxychloroquine was assessed using LPPAI. Also, adverse events were monitored.

Results
Treatment with hydroxychloroquine has a statistically significant effect on decreasing the disease activity after 6 and 12 months of therapy. The results of statistical tests do not confirm the existence of a relationship between age range and treatment efficacy. However, there is a correlation between the duration and efficacy of treatment (p < 0.05).

Conclusions
Administration of hydroxychloroquine can be considered as one of the treatment methods for FFA and LPP in everyday clinical practice. The presented study is the first attempt at using hydroxychloroquine to treat such large patient groups for FFA and LPP. Hydroxychloroquine efficaciously alleviates the symptoms in LPP patients and gives maximum benefits in long-term therapy (12 months). The preliminary results obtained in the presented retrospective analysis should be confirmed in a randomized prospective clinical trial, which remains a future challenge for researchers.