Comparison of efficacy of intra-lesional injections of platelet rich plasma therapy versus intralesional triamcinolone acetonide in the treatment of patients with alopecia areata at a tertiary care hospital
Keywords:
Alopecia Areata, Calcipotriol, Anthraline, Psoriasis, Efficacy, triamcinolone acetonide, Platelet rich plasmaAbstract
Objective Alopecia areata (AA) is a prevalent autoimmune disorder characterized by hair loss triggered by inflammation. Platelet-rich plasma (PRP) has recently gained attention as a novel dermatological treatment, with initial findings indicating its potential benefits in promoting hair growth.  Objective The aim of this study is to evaluate and compare the effectiveness of intralesional injections of platelet-rich plasma therapy with local injections of Triamcinolone acetonide in managing alopecia areata patients.  Methods It is a randomized controlled trial done at Dermatology Department, Mayo Hospital, Lahore from July, 2022 to January, 2023. Group A received intralesional injections of PRP. Group B received intralesional injections of triamcinolone acetonide (10 mg/ml). The two modalities of treatment were given at 0, 4 and 8 weeks and response was assessed after 1 month of completion of treatment The treatment response was assessed using the Severity of Alopecia Tool (SALT) score, after 12 weeks of therapy. The hair regrowth more than 50% from baseline was considered as efficacious.  Results Of these 108 study cases, 41 (38.0 %) were male patients while 67 (62.0 %) were female patients. Mean age of our study cases was 31.28 ± 11.55 years. Mean disease duration was 11.31±7.34 months and 70 (64.8 %) had duration of illness more than 6 months. Efficacy was noted in 45 (41.7%), in group A efficacy was noted in 29 (64%) versus 16 (36%) in group B (P=0.011).  Conclusion The present study revealed that platelet rich plasma injections are effective and safe in patients with alopecia areata compared to Triamcinolone acetonide. Efficacy was higher among patients treated with intra– lesional injections of platelet rich plasma in comparison with Triamcinolone acetonide but not significant as p value (P=0.011). ÂReferences
Meah N, Wall D, York K, Bhoyrul B, Bokhari L, Sigall DA, et al. The Alopecia Areata Consensus of Experts (ACE) study: Results of an international expert opinion on treatments for alopecia areata. J Am Acad Dermatol. 2020;83(1):123-30.
Strazzulla LC, Wang EHC, Avila L, Lo Sicco K, Brinster N, Christiano AM, Shapiro J. Alopecia areata: An appraisal of new treatment approaches and overview of current therapies. J Am Acad Dermatol. 2018;78(1):15-24.
Senna, M., Ko, J., Tosti, A., Edson-Heredia, E., Fenske, D. C., Ellinwood, A. K., Rueda, M. J., Zhu, B., & King, B. Alopecia Areata Treatment Patterns, Healthcare Resource Utilization, and Comorbidities in the US Population Using Insurance Claims. Adv Ther. 2021;38(9):4646-58.
Strazzulla LC, Wang EHC, Avila L, Lo Sicco K, Brinster N, Christiano AM, Shapiro J. Alopecia areata: An appraisal of new treatment approaches and overview of current therapies. J Am Acad Dermatol. 2018;78(1):15-24.
Strazzulla LC, Wang EHC, Avila L, Lo Sicco K, Brinster N, Christiano AM, Shapiro J. Alopecia areata: An appraisal of new treatment approaches and overview of current therapies. J Am Acad Dermatol. 2018;78(1):15-24.
Suchonwanit, P., Kositkuljorn, C., & Pomsoong, C. (2021). Alopecia Areata: An Autoimmune Disease of Multiple Players. Immuno Targets and Therapy.2021;10: 299-12.
Zhou C, Li X, Wang C, Zhang J. Alopecia Areata: an Update on Etiopathogenesis, Diagnosis, and Management. Clin Rev Allergy Immunol. 2021 Aug 17. doi: 10.1007/s12016-021-08883-0. Epub ahead of print. PMID: 34403083.
Balakrishnan A, Joy B, Thyvalappil A, Mathew P, Sreenivasan A, Sridharan R. A Comparative Study of Therapeutic Response to Intralesional Injections of Platelet-Rich Plasma Versus Triamcinolone Acetonide in Alopecia Areata. Indian Dermatol Online J. 2020;11(6):920-24.
Trink, A., Sorbellini, E., Bezzola, P., Rodella, L., Rezzani, R., Ramot, Y., & Rinaldi, F. (2013). A randomized, double-blind, placebo- and active-controlled, half-head study to evaluate the effects of platelet-rich plasma on alopecia areata. Br J Dermatol. 2013;169(3):690–4.
Khademi F, Tehranchinia Z, Abdollahimajd F, Younespour S, Kazemi-Bajestani SMR, Taheri K. The effect of platelet rich plasma on hair regrowth in patients with alopecia areata totalis: A clinical pilot study. Dermatol Ther. 2019;32(4):e12989
Shumez H1, Prasad PVS2, Kaviarasan PK3, Deepika R. Intralesional platelet rich plasma vs. intralesional triamcinolone in the treatment of alopecia areata: A comparative study. Int J Med Res Health Sci. 2015;4(1):118-22.