Lichen Planopilaris patient successfully transplanted in one session; Dr. Beehner

[Dr. Michael Beehner]

This 61 y/o male was diagnosed 12 years ago with hair loss caused by Lichen Planopilaris, which causes a "scarring alopecia." He had an acute flare-up 5 years later in 2007, and claims it has been "dormant" since 2011.

As a precaution we did "test grafts", which are seen in the last three photos. The bare area we did the testing in is first shown, and then the recipient sites being made there, and finally, the growth of hairs in that study box.

He had his first session performed by myself in July of 2012. He had very good growth from the transplant. He was in the other day for a second session of 1218 grafts to increase density. His first session consisted of 1348 grafts, comprising 4127 hairs. 270 MFU grafts and 1078 FU's were used.

Usually, but not always, Lichen-planopilaris "burns out" and stays that way. Sometimes it can come back, in which case it is important for a patient who has been transplanted to get into his dermatologist for immediate treatment to calm things down and save the grafts. Steroid iinjections into the lesions is the treatment of choice. It is thought to be an auto-immune condition.

Mike Beehner, M.D.

[TakingThePlunge]

Very interesting case Dr. Beehner. Thank you for sharing this patient's results. I hope his condition remains dormant.

[hsrp10]

indeed interesting case, and very nice results using minimal graft count

how is Lichen-planopilaris diagnosed btw? is it just a visual diagnosis or are there tests?

[Blake Bloxham]

Very interesting! Thank you for sharing.

[Dr. Michael Beehner]

In answer to the person who asked how Lichen Planopilaris is diagnosed, the clinical picture and a biopsy are the usual ways to do so. It is thought to probably be of an autoimmune etiology. It can sometimes overlap with Alopecia Areata in its clinical appearance, but usually is more "splotchy" with multiple,small patches irregularly spread all over the head, including in the donor area. It leaves a "scarring alopecia" result, which means that in each of these little bald patches there are no pores or follicular elements of any sort. We usually wait at least two years after any sign of disease activity (enlarging, redness, scaling) before considering transplanting. Some hair surgeons will then perform a repeat biopsy to make sure there are no lymphocytes present around nearby follicles near the edge of these lesions before transplanting. When the diagnosis has already been confirmed before a patient reaches me, I will often give the patient the choice between re-biopsying or doing test grafts, which this patient chose to do. The good news about this diagnosis, as opposed to alopecia areata, is that it often will "burn out" and remain inactive for a long time or for that patient's life span. I have transplanted around 10 of these patients and have only had one re-activate. The treatment is steroid injections in the scalp in the area affected. Frontal fibrosing alopecia, which affects mainly the front hairline, beard or eyebrows is thought to be a sub-type of LPP.

Mike

[napavalley]

Thanks, I have lived with LPP for 40 years 2 failed HTs. I'm thrilled about new treatments that are now available. Dr Mirmirani's studies treating LPP with a Peroxisome Prolifeator--Activated Receptor shows great promise. I'm lucky that I live in California and live less than an hour from her office. She has a 4 to 6 month wait but I'm willing to wait if there is a hope give me help. Dr Mirmirani has write a book with renowned scalp and hair specialist Dr Vera Price.

[JON86]

Thanks, I have lived with LPP for 40 years 2 failed HTs. I'm thrilled about new treatments that are now available. Dr Mirmirani's studies treating LPP with a Peroxisome Prolifeator--Activated Receptor shows great promise. I'm lucky that I live in California and live less than an hour from her office. She has a 4 to 6 month wait but I'm willing to wait if there is a hope give me help. Dr Mirmirani has write a book with renowned scalp and hair specialist Dr Vera Price.

 

I have read about this condition and am sorry you have it. I hope that this doctor can help you. I wish you the best.

[napavalley]

Jon86, thanks I'm 63 years old lucky that after 40 years I only have scarring in the crown about the size of a silver dollar. I've been diagnosed in the right temple for late stage LPP. It is still active in the crown. It was hard to see about half of all the 1542 grafts disappear last year within a year after My second HT. I'm now taking it slowly with one of the forum doctors. Feel good that the next HT will be successful. Thanks again.

[JON86]

I have had some really bad experiences with doctors trying to persuade me

and nickle and dime me. My search of ethics lead me to the same Doctor you are dealing with. Konior is not only an amazing doctor but an amazing person as well. He has the highest ethics of any surgeon I have encountered. He cares about his patients more than money. I have gotten great information from him and have not had to pay a dime. There are many great doctors out there I am not saying he is the only one but for me he is the choice. You are in great hands with him.

[NewHare]

Great coverage for only 2500+ grafts. Nice job doctor.

[napavalley]

Dr. great job, it is allot more work over a longer period of time, but well worth it. My plan with Dr. Konior is to do a scalp reduction on the crown scarring and take small test samples once I have clearance with dermatologist on my LPP inactivity. Thanks for sharing, I know that it is not as interesting for other members that don't have this issue but it is good to see great results.

Edited February 10, 2016 by napavalley