Alopecia areata (AA) is a disease that affects the psychological well‐being of the affected individuals. Laser‐assisted drug delivery and microneedling (MN) are promising methods for the treatment of different dermatological diseases. The aim of the study was to compare the efficacy of topical application of triamcinolone acetonide after fractional carbon dioxide laser versus MN in the treatment of resistant AA from a clinical and dermoscopic perspective. Thirty patients were randomly divided into two groups of 15 patients each: the Laser group received fractional CO2 laser treatment followed by topical application of triamcinolone acetonide, and the MN group received dermapen treatment followed by topical application of triamcinolone acetonide. In our study, we found no statistically significant difference between the studied groups before and after treatment, except for black dot, which is higher in the MN group than in the laser group (46.7% vs. 13.3%). There is a statistically significant difference between the studied groups in terms of treatment response at the first follow‐up, with 13.3% of the laser group seeing terminal hair regrowth compared to 0 in the MN group after 12 weeks. Regarding the degree of improvement, there was no statistically significant difference between the laser group and the MN group. The use of fractional CO2 laser and MN for transepidermal drug delivery (TED) allowed for more uniform drug distribution. There was no significant difference between the two treatment methods in terms of their high effectiveness in the treatment of resistant AA.
Background: Many treatment options were used for Vitiligo. But there is no consensus on the precise treatment modality. Aim of the work:The study aimed to assess and compare the efficacy of microneedling combined with trichloracetic acid [TCA] versus micro-needling with tacrolimus in the treatment of Vitiligo, Patients and Methods: 60 Vitiligo were included and classified into two equal groups. Group [A] included 30 patients who received micro-needling with dermapen then tacrolimus 0.03 ointments every two weeks for six sessions. Group B included thirty patients who received micro-needling with dermapen then TCA 25% every two weeks for six sessions. The outcome was documented. Results: The repigmentation was slightly higher in TCA-treated patches than with tacrolimus. Excellent response in repigmentation occurred in 43.3%of TCA patches. In contrast, in 16.7% of tacrolimus-treated patches, Good improvement occurred in13.3% of TCA-treated patches while 23.3% of tacrolimustreated patches. Moderate improvement occurred in10.0% TCA -treated patches while 30.0% of tacrolimus-treated patches, mild improvement occurred in 13.3% of TCA -treated patches. In comparison, only in 16.7% of tacrolimus-treated patches, However, there was a great difference between the two drugs regarding erythema, inflammation, and exfoliations, which occurred mainly with TCA. Conclusion:The mix of microneedling with either TCA 25% or tacrolimus is effective and safe in treating Vitiligo.However, TCA achieved a slightly increased percentage of repigmentation than tacrolimus.
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