Best dilution of the best corticosteroid for intralesional injection in the treatment of localized alopecia areata in adults

Purpose: To evaluate and compare the clinical efficacy, dermoscopic results and safety of triamcinolone acetonide (TA) and betamethasone dipropionate (BD) injections at different concentrations in localized scalp and beard alopecia. Methods: Intralesional injection of BD or TA in three different dil...

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Bibliographic Details
Published in:The Journal of dermatological treatment 2017-11, Vol.28 (8), p.753-761
Main Authors: Ustuner, Pelin, Balevi, Ali, Özdemir, Mustafa
Format: Article
Language:English
Subjects:
Adolescent
Adult
Alopecia
alopecia areata
Alopecia Areata - drug therapy
Betamethasone - administration & dosage
Betamethasone - analogs & derivatives
Betamethasone - chemistry
betamethasone dipropionate
Dermoscopy
Dose-Response Relationship, Drug
Female
Humans
Immunosuppressive Agents - administration & dosage
Immunosuppressive Agents - chemistry
injections
Injections, Intralesional
intralesional
Male
Middle Aged
Treatment Outcome
triamcinolone acetonide
Triamcinolone Acetonide - administration & dosage
Triamcinolone Acetonide - chemistry
Young Adult
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Summary:Purpose: To evaluate and compare the clinical efficacy, dermoscopic results and safety of triamcinolone acetonide (TA) and betamethasone dipropionate (BD) injections at different concentrations in localized scalp and beard alopecia. Methods: Intralesional injection of BD or TA in three different dilutions; 1/4, 1/8, 1/12 (BD1, BD2, BD3, TA1, TA2, TA3) and Saline (control) was randomly applied to a total of 231 alopecia patches in 83 patients every four weeks in a maximum of six sessions until a hair regrowth score of 4 was achieved. The number of required sessions, sixth-month hair regrowth scores, treatment success rates and dermoscopic data were investigated. Results: The mean number of required sessions were similar and significantly lower in BD1 and TA1 being 4.21 ± 1.12 and 3.74 ± 0.99, respectively. Dermoscopic examinations revealed similar terminal hair growth rations in Saline (30.3%), BD1 (44.4%) and TA1 (42.9%). However, sixth-month hair regrowth scores, overall treatment success rates and percentage of terminal hair regrowth were similar in BD1 and TA1. However, adverse effects were more common in TA groups (24.3%) than in BD groups (10.6%) at the sixth month. Conclusions: BD ¼ dilution (1.25 mg/dL) seems best corticosteroid for intralesional injection in the treatment of localized alopecia areata in adults.
ISSN:0954-6634
1471-1753
DOI:10.1080/09546634.2017.1329497