Pruritus in Lichen Planopilaris and Frontal Fibrosing Alopecia—Clinical Characteristics and Dermoscopic Correlations
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Assessment of Itch
2.3. Dermoscopy (Trichoscopy)
2.4. Statistical Analysis
3. Results
3.1. Clinical Characteristics of the Study Population
3.2. Frequency and Duration of Itch
3.3. Intensity of Itch
3.4. Itch-Accompanying Sensations and Sleeping Problems
3.5. Factors Influencing Itch
3.6. Comparison of Itch Characteristics in Patients with LPP, FFA and LPP-FFA
3.7. Correlation of Itch with Dermoscopic Findings
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Patient Characteristics | Total (n = 61) | LPP (n = 16) | FFA (n = 33) | LPP-FFA (n = 12) |
---|---|---|---|---|
Sex, n (%) | ||||
Women | 53 (86.9) | 9 (56.3) | 32 (97.0) | 12 (100.0) |
Men | 8 (13.1) | 7 (43.7) | 1 (3.0) | 0 (0.0) |
Age (years), mean ± SD | 58.8 ± 12.9 | 55.0 ± 14.1 | 58.6 ± 11.6 | 64.5 ± 14.1 |
Range | 26–83 | 26–74 | 33–83 | 36–81 |
Disease duration (months), mean ± SD | 76 ± 105.8 | 40.9 ± 47.3 | 69.3 ± 95.0 | 141.2 ± 161.7 |
Range | 4–540 | 6–180 | 4–540 | 11–480 |
Duration of the current exacerbation (months), mean ± SD | 47.6 ± 83.9 | 32.5 ± 32.3 | 51.5 ± 95.4 | 56.8 ± 102.3 |
Range | 0–540 | 3–120 | 0–540 | 2–360 |
Patient Characteristics | Total (n = 61) | LPP (n = 16) | FFA (n = 33) | LPP—FFA (n = 12) | p Value |
---|---|---|---|---|---|
Presence of pruritus, n (%) | 45 (73.8) | 13 (81.3) | 21 (63.6) | 11 (91.6) | ns |
VASexam (cm) | ns | ||||
mean ± SD | 2.4 ± 2.4 | 2.8 ± 2.6 | 2.0 ± 2.5 | 2.8 ± 2.2 | |
range | 0–8.9 | 0–8.5 | 0–8.9 | 0–6.2 | |
VASmax (cm) | ns | ||||
mean ± SD | 5.3 ± 3.1 | 6.2 ± 2.6 | 4.6 ± 3.2 | 5.9 ± 3.3 | |
range | 0.5–10 | 2.3–10 | 0.1–10 | 0.7–9.8 | |
VASmosquito (cm) | ns | ||||
mean ± SD | 5.7 ± 2.6 | 5.9 ± 2.1 | 5.5 ± 2.7 | 5.9 ± 3.1 | |
range | 0–10 | 3.5–9.1 | 0–10 | 0.7–9.7 | |
4-item itch questionnaire (points) | ns | ||||
mean ± SD | 6.4 ± 2.7 | 5.8 ± 1.9 | 6.7 ± 3.1 | 6.4 ± 2.9 | |
range | 3–15 | 4–10 | 4–15 | 3–12 | |
Duration of pruritus, n (%) | ns | ||||
<1 min | 16 (26.2) | 5 (31.3) | 8 (24.2) | 3 (25.0) | |
Several minutes | 15 (24.6) | 4 (25.0) | 5 (15.2) | 6 (50.0) | |
>10 min | 14 (23) | 4 (25.0) | 8 (24.2) | 2 (16.7) | |
Frequency of pruritus, n (%) | ns | ||||
Every day | 22 (36.1) | 6 (37.5) | 10 (30.3) | 6 (50.0) | |
Several times/week | 18 (29.5) | 7 (43.8) | 7 (21.2) | 3 (25.0) | |
Several times/month | 5 (8.2) | 0 (0.0) | 4 (12.1) | 2 (16.7) | |
Less than 1/month | 16 (26.2) | 3 (18.8) | 12 (36.4) | 1 (8.3) | |
Preparations used to reduce itching, n (%) | ns | ||||
Corticosteroids | 6 (9.8) | 3 (18.8) | 2 (6.1) | 1 (8.3) | |
Emollients | 3 (4.9) | 1 (6.3) | 1 (3.0) | 1 (8.3) | |
Anti-dandruff shampoos | 2 (3.3) | 0 (0.0) | 1 (3.0) | 1 (8.3) | |
Time of the day of pruritus, n (%) | ns | ||||
Morning | 41 (67.2) | 12 (75) | 19 (57.6) | 10 (83.3) | |
Afternoon | 39 (63.9) | 12 (75) | 17 (51.5) | 10 (83.3) | |
Evening | 41 (67.2) | 11 (68.8) | 20 (60.6) | 10 83.3) | |
Night | 17 (27.9) | 6 (37.5) | 8 (24.2) | 3 (25.0) | |
Itch-associated sensations, n (%) | ns | ||||
Tickling | 8 (13.11) | 4 (25.0) | 3 (9.1) | 1 (8.3) | |
Pricking | 3 (4.92) | 0 (0.0) | 2 (6.1) | 1 (8.3) | |
Tingling | 12 (19.67) | 3 (18.8) | 8 (24.2) | 1 (8.3) | |
Pinching | 8 (13.11) | 1 (6.3) | 4 (12.1) | 3 (25.0) | |
Burning sensation | 9 (14.75) | 3 (18.8) | 4 (12.1) | 2 (16.7) | |
Itch perception, n (%) | ns | ||||
Burdensome | 10 (16.4) | 2 (12.5) | 5 (15.2) | 3 (25.0) | |
Irritating | 20 (32.8) | 7 (43.8) | 8 (24.2) | 5 (41.7) | |
Unbearable | 5 (8.2) | 2 (12.5) | 1 (3.0) | 2 (16.7) | |
Disturbing | 11 (18.0) | 2 (12.5) | 6 (18.2) | 3 (25.0) | |
Difficulties falling asleep, n (%) | ns | ||||
Nearly always | 4 (6.6) | 0 (0.0) | 3 (9.1) | 1 (8.3) | |
Rarely | 8 (13.1) | 5 (31.3) | 1 (3.0) | 2 (16.7) | |
never | 32 (52.5) | 7 (43.8) | 17 (51.5) | 8 (66.7) | |
Waking up from sleep, n (%) | ns | ||||
Nearly always | 4 (6.6) | 0 (0.0) | 3 (9.1) | 1 (8.3) | |
Rarely | 6 (9.8) | 2 (12.5) | 2 (6.1) | 2 (16.7) | |
Never | 33 (54.1) | 9 (56.3) | 16 (48.5) | 8 (66.7) | |
Use of sedatives, n (%) | ns | ||||
Nearly always | 2 (3.3) | 0 (0.0) | 2 (6.1) | 0 (0.0) | |
Rarely | 4 (6.8) | 1 (6.3) | 1 (3.0) | 2 (16.7) | |
Never | 37 (60.7) | 10 (62.5) | 18 (54.5) | 9 (75.0) | |
Exacerbating factors, n (%) | ns | ||||
Sleep | 2 (3.3) | 1 (6.3) | 1 (3.0) | 0 (0.0) | |
Physical activity | 13 (21.3) | 3 (18.8) | 8 (24.2) | 2 (16.7) | |
Stress | 17 (27.9) | 3 (18.8) | 10 (30.3) | 4 (33.3) | |
Fatigue | 16 (26.2) | 2 (12.5) | 11 (33.3) | 3 (25.0) | |
Diet | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | |
Hot water | 17 (27.9) | 5 (31.3) | 6 (18.2) | 6 (50.0) | |
Cold water | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | |
Dry air | 10 (16.4) | 1 (6.3) | 8 (24.2) | 1 (8.3) | |
Sweat | 25 (41.0) | 7 (43.8) | 14 (42.4) | 4 (33.3) | |
Cold | 2 (3.3) | 0 (0.0) | 1 (3.0) | 1 (8.3) | |
Warmth | 23 (37.7) | 5 (31.3) | 12 (36.4) | 6 (50.0) | |
Alleviating factors, n (%) | ns | ||||
Sleep | 4 (6.6) | 0 (0.0) | 3 (9.1) | 1 (8.3) | |
Physical activity | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | |
Stress | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | |
Fatigue | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | |
Diet | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | |
Hot water | 1 (1.6) | 0 (0.0) | 1 (3.0) | 0 (0.0) | |
Cold water | 11 (18) | 1 (6.3) | 5 (15.2) | 5 (41.7) | |
Dry air | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | |
Sweat | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | |
Cold | 9 (14.8) | 2 (12.5) | 5 (15.2) | 2 (16.7) | |
Warmth | 1 (1.6) | 0 (0.0) | 1 (3.0) | 0 (0.0) | |
Psychological well-being, n (%) | ns | ||||
No change | 17 (27.9) | 4 (25) | 9 (27.3) | 4 (33.3) | |
Decreased mood | 13 (21.3) | 2 (12.5) | 7 (21.2) | 4 (33.3) | |
Increased mood | 1 (1.6) | 0 (0.0) | 1 (3.0) | 0 (0.0) | |
Problems with concentration | 7 (11.5) | 3 (18.8) | 2 (6.1) | 2 (16.7) | |
Anxiety | 5 (8.2) | 2 (12.5) | 0 (0.0) | 3 (25.0) | |
Anger | 1 (1.6) | 1 (6.3) | 1 (3.0) | 0 (0.0) | |
Irritation | 3 (94.9) | 0 (0.0) | 2 (6.1) | 0 (0.0) |
Dermoscopic Features, n (%) | Total (n = 61) | LPP (n = 16) | FFA (n = 33) | LPP—FFA (n = 12) | p Value |
---|---|---|---|---|---|
Absence of openings | 61 (100.0) | 16 (100.0) | 33 (100.0) | 12 (100.0) | 1.000 |
White dots | 20 (32.8) | 6 (37.5) | 9 (27.3) | 5 (41.7) | 0.593 |
Yellow dots | 10 (16.4) | 2 (12.5) | 6 (18.2) | 2 (15.7) | 0.880 |
Red follicular dots | 7 (11.5) | 4 (25.0) | 3 (9.1) | 0 (0.0) | 0.099 |
Dilated follicles | 7 (11.5) | 4 (25.0) | 2 (6.1) | 1 (8.3) | 0.139 |
Hair diameter diversity | 37 (60.7) | 7 (43.8) | 21 (63.6) | 9 (75.0) | 0.215 |
Pili torti | 17 (27.9) | 2 (12.5) | 13 (39.4) | 2 (15.7) | 0.090 |
Broken hair | 3 (4.9) | 1 (6.3) | 1 (3.0) | 1 (8.3) | 0.737 |
Perifollicular erythema | 50 (82.0) | 14 (87.5) | 25 (75.8) | 11 (91.7) | 0.376 |
Perifollicular scaling | 43 (70.5) | 14 (87.5) | 18 (54.5) | 11 (91.7) | 0.012 * |
Perifollicular pigmentation | 39 (63.9) | 11 (68.8) | 19 (57.6) | 9 (75.0) | 0.502 |
White halo | 24 (39.3) | 8 (50.0) | 9 (27.3) | 7 (58.3) | 0.101 |
Interfollicular white structureless areas | 59 (96.7) | 16 (100.0) | 31 (93.9) | 12 (100.0) | 0.416 |
Interfollicular pink structureless areas | 51 (83.6) | 12 (75.0) | 27 (81.8) | 12 (100.0) | 0.193 |
Interfollicular white scales | 15 (24.6) | 5 (31.3) | 6 (18.2) | 4 (33.3) | 0.447 |
Interfollicular yellow scales | 2 (3.3) | 2 (12.5) | 0 (0.0) | 0 (0.0) | 0.055 |
Honeycomb pigmented pattern | 12 (19.7) | 5 (31.3) | 5 (15.2) | 2 (16.7) | 0.396 |
Hemorrhages | 1 (1.6) | 0 (0.0) | 0 (0.0) | 1 (8.3) | 0.125 |
Erosions | 1 (1.6) | 0 (0.0) | 0 (0.0) | 1 (8.3) | 0.125 |
Pruritus, n (%) | VASexam | VASmax | |||||||
---|---|---|---|---|---|---|---|---|---|
Dermoscopic Finding | Yes | No | p Value | Mean ± SD | Median | p Value | Mean ± SD | Median | p Value |
Hair diameter diversity | |||||||||
yes | 32 (52.5) | 5 (8.2) | 2.4 ± 2.5 | 2.2 | 5.5 ± 2.8 | 5.9 | |||
no | 13 (21.3) | 11 (18.0) | 0.008 * | 3.1 ± 2.1 | 3.2 | 0.402 | 6.5 ± 2.8 | 6.9 | 0.102 |
Perifollicular scaling | |||||||||
Yes | 36 (59.0) | 7 (11.5) | 2.6 ± 2.3 | 2.3 | 6.1 ± 2.8 | 6.6 | |||
no | 9 (14.8) | 9 (14.8) | 0.011 * | 2.8 ± 3.1 | 2.3 | 0.068 | 4.5 ± 2.9 | 5.3 | 0.005 * |
Perifollicular erythema | |||||||||
yes | 39 (63.9) | 11 (18.0) | 2.5 ± 2.4 | 2.2 | 5.8 ± 3.0 | 6.3 | |||
no | 6 (9.8) | 5 (8.2) | 0.137 | 3.1 ± 2.3 | 3.8 | 0.523 | 5.6 ± 1.7 | 6.2 | 0.205 |
White halo | |||||||||
Yes | 22 (36.1) | 2 (3.3) | 2.1 ± 2.5 | 1.7 | 5.4 ± 3.0 | 6.0 | |||
no | 23 (37.7) | 14 (23.0) | 0.016 * | 3.1 ± 2.3 | 3.3 | 0.599 | 6.2 ± 2.7 | 6.6 | 0.164 |
Yellow dots | |||||||||
Yes | 10 (16.4) | 0 (0.0) | 3.0 ± 1.9 | 2.5 | 5.6 ± 2.4 | 6.2 | |||
no | 35 (57.4) | 16 (26.2) | 0.051 | 2.5 ± 2.5 | 2.2 | 0.020 * | 5.8 ± 3.0 | 6.6 | 0.202 |
Honeycomb pigment pattern | |||||||||
Yes | 6 (9.8) | 6 (9.8) | 1.4 ± 2.0 | 0.4 | 5.0 ± 2.6 | 6.0 | |||
no | 39 (63.9) | 10 (16.4) | 0.063 | 2.8 ± 2.4 | 2.3 | 0.012 * | 5.9 ± 2.9 | 6.3 | 0.037 * |
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Kołcz, K.; Krawczyk-Wołoszyn, K.; Reich, A.; Żychowska, M. Pruritus in Lichen Planopilaris and Frontal Fibrosing Alopecia—Clinical Characteristics and Dermoscopic Correlations. J. Clin. Med. 2024, 13, 4898. https://doi.org/10.3390/jcm13164898
Kołcz K, Krawczyk-Wołoszyn K, Reich A, Żychowska M. Pruritus in Lichen Planopilaris and Frontal Fibrosing Alopecia—Clinical Characteristics and Dermoscopic Correlations. Journal of Clinical Medicine. 2024; 13(16):4898. https://doi.org/10.3390/jcm13164898
Chicago/Turabian StyleKołcz, Kinga, Karolina Krawczyk-Wołoszyn, Adam Reich, and Magdalena Żychowska. 2024. "Pruritus in Lichen Planopilaris and Frontal Fibrosing Alopecia—Clinical Characteristics and Dermoscopic Correlations" Journal of Clinical Medicine 13, no. 16: 4898. https://doi.org/10.3390/jcm13164898