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Clinical Effectiveness of Two Old Immunosuppressant Drugs, Methotrexate and Azathioprine, in the Treatment of Lichen Planopilaris: A Randomized Clinical Trial Publisher



Saber M ; Hajheidari P ; Naeini FF ; Mohaghegh F
Authors

Source: Dermatologic Therapy Published:2024


Abstract

Background. Lichen planopilaris is the leading cause of cicatricial alopecia, and its management is challenging for dermatologists. It is a cell-mediated autoimmune disorder in which activated T-lymphocytes attack hair follicles. Aim. To compare the efcacy and safety of methotrexate versus azathioprine, two medications that afect lymphocyte function, in treating LPP. Methods. 32 LPP patients were randomly assigned to receive either 15 mg/week methotrexate or 2 mg/kg azathioprine for six months. Treatment efcacy was evaluated using the Lichen Planopilaris Activity Index (LPPAI), trichoscopy, and photography after 2, 4, and 6 months of treatment. Results. Both methotrexate and azathioprine groups showed signifcant improvements in LPPAI (P < 0.001) and perifollicular scaling on trichoscopy (P < 0.01). However, the two groups had no signifcant diference during the study. Te azathioprine group signifcantly improved perifollicular erythema on trichoscopy (P = 0.002), but this was not signifcantly diferent from the methotrexate group (P = 0.69). Photographic assessment showed that more than 75% of patients in both groups improved without signifcant diferences between the two groups. Conclusion. Methotrexate and azathioprine are two antilymphocyte medications which are both equally efective and well-tolerated for managing LPP. Tis trial is registered with IRCT20191006045005N2. © 2024 Mina Saber et al.
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