Lichen Planopilaris and the Eye
In the pathways that lead to scarring alopecia, there is a close (but poorly understood) relationship between hair follicles and oil glands. In fact, inflammation and reduction in oil glands in the scalp appear to be one of the various first steps in lichen planopilaris.
Although eyelashes can be lost in lichen planopilaris and closely related frontal fibrosing alopecia, there has been little study of how the oil glands in eyelashes are altered in patients with lichen planopilaris.
The oil glands of the eyelid are known as “meibomian glands” and they have a key role in secreting an oily substance meibum which helps prevent evaporation of tear film. Without meibomian glands, our tears would evaporate quickly or constantly run onto the face. There are about 50 such glands in the upper eyelid and 25 in the lower eyelid.
Problems within the Meibomian glands are increasingly recognized by eye doctors under the term “meibomian gland dysfunction” (MGD) and are a major cause of dry eye.
In a new study, researchers set out to study whether meibomian gland dysfunction is present in patients with lichen planopilaris. They performed a case-control study involving 23 patients with histologically confirmed LPP and 23 healthy controls. The researchers used a specific test known as “tear breakup time” as a measure of meibomian gland function.
Interestingly, patients with LPP had different results than controls. Specifically, patients with LPP had lower tear breakup time meaning that evaporation of tears occurred more readily in patients with LPP.
Other findings of the eye examinations were normal in patients with LPP including conjunctiva, lid margin shape, eye pressures, and fundoscopy.
In summary, patients with LPP scored worse in ocular surface tests. This study draws attention to the importance of monitoring for dry eye and meibomian gland dysfunction in patients with LPP.
Gheisari M et al. Ocular Surface Findings in Patients With Lichen Planopilaris. Cornea. 2018.
Dr. Jeff Donovan is a Canadian and US board certified dermatologist specializing exclusively in hair loss. To schedule a consultation, please call the Whistler office at 604.283.1887