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March 2011March 21, 2011

Top-Accessed Article: Lichen Planopilaris Treated With a Peroxisome Proliferator–Activated Receptor γ Agonist

Author Affiliations

Author Affiliations: Department of Dermatology, Henry Ford Hospital, Detroit, Michigan.

Arch Dermatol. 2011;147(3):284. doi:10.1001/archdermatol.2011.18

Mirmirani P, Karnik P. Lichen planopilaris treated with a peroxisome proliferator-activated receptor γ agonist. Arch Dermatol.2009;145(12):1363-1366.

Based on laboratory studies, the transcription factor peroxisome proliferator–activated receptor γ (PPAR-γ) has an important role in normal pilosebaceous development, while its dysfunction may contribute to the pathogenesis of lichen planopilaris (LPP).1 Extrapolating these findings clinically, Mirmirani and Karnik reported the successful treatment of LPP in a patient who received an 8-month course of the PPAR-γ agonist pioglitazone hydrochloride (15 mg/d). The pruritus resolved within 1 month, and the patient remained in remission 1 year after treatment. A biopsy specimen obtained after 6 months of treatment verified a decrease in inflammation. Therapies directed toward PPAR-γ dysfunction in LPP depart from the traditional yet variably successful therapeutic paradigm of immunosuppression. Additional studies are needed to confirm these findings, but this case report provides preliminary evidence that PPAR-γ agonists may be a valuable new therapeutic option for LPP.