Vol. 6, Issue 1, Part A (2024)

Background: Alopecia areata (AA) is nonscarring patchy area of hair loss. Platelets rich plasma (PRP) promotes development of new hair follicles. Dermoscopy is a diagnostic tool that helps in evaluation of skin microstructures which are not visible to naked eye.
Aim of the study: The aim of the current study was to compare the therapeutic response of intralesional injections of platelet-rich plasma (PRP) with triamcinolone acetonide in the treatment of alopecia areata
Patients and Methods: This randomized double-blind study involved 50 Alopecia areata patients at Salah Aldin General Hospital. Patients were divided into two groups: group A who received PRP injection and group B who received intralesional triamcinolone acetonide. The study included patients who were willing to participate, had a circumscribed patch of hair loss without inflammation or scarring, had not taken any treatment for alopecia areata in the last 3 months, and were over 18 years old. Exclusion criteria included not participating, pregnant or lactating patients, extensive lesions, or having alopecia in areas other than the scalp. The two treatment modalities were continued for 12 weeks at intervals of 4 weeks apart and followed up at every visit. A digital photograph of the patches was taken at every visit and evaluated. The response was analyzed using the SALT score, severity of alopecia tool score, and hair regrowth grade (HRG) scale. The SALT score is the sum of percentage of hair loss in all areas. The grading system used was the Mac Donald Hull and Norris system.
Results: Our findings reveal a predominance of males in the AA patient population, comprising 80% of the total sample, with a male-to-female ratio of 2:1. The mean age of onset is 26.87 years, with nearly half of the patients experiencing AA for less than six months. The severity of AA, as assessed by the Severity of Alopecia Tool (SALT) score, averages at 6.87 ± 5.65. A history of atopy is present in 22% of patients, while nail diseases are prevalent in 48% of cases. Over half of the patients exhibit a past history of similar lesions, suggesting a recurring pattern, and 8% present with other skin lesions. The majority of cases manifest suddenly, predominantly affecting the scalp (64%) followed by the beard area (36%). Patchy alopecia is the most common pattern of hair loss, with well-defined borders observed in 70% of cases. Treatment outcomes reveal a consistent trend in SALT scores, with PRP therapy demonstrating superior efficacy compared to intralesional triamcinolone acetonide. Across all visits, PRP-treated patients consistently exhibited lower mean SALT scores, indicating a more favorable response to treatment. The statistically significant p-values (<0.001) further support the superiority of PRP therapy. The comparison of efficacy between PRP and intralesional triamcinolone acetonide highlights notable differences, with a higher proportion of patients experiencing efficacy in the PRP group. According to the Mac Donald Hull and Norris grading system, PRP therapy resulted in a higher percentage of excellent and good responses compared to intralesional triamcinolone acetonide. In conclusion, PRP therapy shows promising efficacy in the management of AA, offering superior outcomes compared to intralesional triamcinolone acetonide. These findings underscore the potential of PRP as a valuable treatment modality for AA patients, warranting further investigation and clinical consideration.