WEDNESDAY, Nov. 13, 2024 -- Exogenous gonadocorticoid exposure is associated with increased odds of lichen planopilaris (LPP) and frontal fibrosing alopecia (FFA), according to a research letter published online Oct. 28 in the Journal of the American Academy of Dermatology.

Amit Singal, from the Rutgers New Jersey Medical School in Newark, and colleagues examined potential LPP/FFA associations with exogenous gonadocorticoids using a multicenter database from 2004 to 2024. Data were included for 34,238 female and 11,717 male LPP/FFA patients and an equal numbers of matched controls.

The researchers found that compared with female controls, female LPP/FFA patients had a higher prevalence of hormonal contraceptive (8.53 versus 5.21 percent), exogenous androgen (0.68 versus 0.11 percent), and anabolic steroid exposure (0.28 versus 0.05 percent), and they had a lower prevalence of hormone replacement therapy (HRT) exposure (1.69 versus 1.99 percent). Compared with male controls, male LPP/FFA patients had a higher prevalence of exogenous androgen exposure (2.27 versus 0.68 percent). Increased odds of LPP/FFA were seen for women with exposure to anabolic steroids, HRT, exogenous androgens, and hormonal contraceptives compared with female controls (odds ratios, 5.19, 3.87, 3.72, and 2.92, respectively). Men with exposure to exogenous androgens had increased odds of LPP/FFA compared with controls (odds ratio, 5.78).

"Dermatologists could consider endocrine/urology/gynecology consultation for patients with early LPP/FFA taking gonadocorticoids to weigh risks/benefits of therapy," the authors write.

One author disclosed serving as a consultant for Ortho-Dermatologics, Moberg Pharma, BelleTorus Corporation, and Eli Lilly.