Quality-of-life assessment and the impact of early diagnosis and treatment in lichen planopilaris: a systematic review

Lichen planopilaris (LPP) and its variants, mainly frontal fibrosing alopecia (FFA), affect the hair follicles, causing cicatricial alopecia. The condition has a significant negative impact on self-confidence and quality of life (QoL). This systematic review investigates the psychoemotional impact of LPP and its variants using the PRISMA guidelines. The review revealed that LPP and FFA cause significant psychological distress and impaired QoL. Higher LPP disease activity and severity were associated with higher depression and anxiety scores, lower quality-of-life scores, and higher scores of role limitations (physical and emotional). Additionally, facial lesions in patients with FFA, especially with eyebrow involvement, can be very distressing, leading to impaired self-esteem and reduced QoL. This negative impact of active and severe LPP and FFA on patients' QoL and self-esteem causes psychiatric conditions including anxiety and depression. Therefore, an early diagnosis must be encouraged in these patients. Lichen planopilaris (LPP) and frontal fibrosing alopecia are chronic inflammatory diseases of the same spectrum. Both affect the hair follicles, causing alopecia with permanent hair loss. These conditions usually cause a significant negative impact on self-esteem, self-confidence, self-consciousness and quality of life, leading to higher levels of anxiety and depression. This manuscript investigates the psychoemotional impact of LPP and its variants on the quality of life of these patients.