Nemolizumab to Treat Lichen Planopilaris, a Noncontrolled, Prospective, Pilot Study.
Lichen planopilaris (LPP) is a primary lymphocytic cicatricial alopecia characterized by progressive, permanent hair loss and scalp symptoms such as pruritus and burning. Current treatments-including topical and intralesional corticosteroids, hydroxychloroquine, and immunosuppressants-are often inadequate, with limited evidence for efficacy and frequent treatment switching or discontinuation due to side effects or lack of response.1,2 Recent systematic reviews and meta-analyses highlight the need for new, targeted therapies. 3,4 Nemolizumab, an IL-31 receptor antagonist, FDA-approved for prurigo nodularis and atopic dermatitis, has demonstrated efficacy in pruritic and fibrosing dermatoses, making it a rational candidate for LPP.
• Age ≥18 years.
• Clinical and/or histopathologic diagnosis of LPP.
• Presence of scalp pruritus.
• Average Peak Pruritus Numerical Rating Scale (PP-NRS) score ≥4 in the 7 days prior to Day 1.
• Ability and willingness to provide written informed consent and comply with study procedures.
• Willingness to undergo optional scalp biopsy for research purposes.