Assay of 0.2 % Fluocinolone Acetonide Cream for Alopecia Areata and Totalis

Pascher, Frances; Kurtin, Stephen B.; Andrade, Raquel Machado

doi:10.1159/000252466

Cited by 67 publications

(21 citation statements)

References 6 publications

(8 reference statements)

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“…This initial response was sustained in 71% of patients. Children less than 10 years of age having AA of less than 1‐year's duration responded better (18). The dropout rate (40%) in this study was very high.…”

mentioning

confidence: 56%

The treatment of alopecia areata

Bolduc

Shapiro²

2001

Dermatol Ther

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This article reviews the different treatments of alopecia areata (AA). The information includes both a review of the literature as well as practical aspects regarding the use of the most commonly used therapies for AA. These modalties are summarized in a practical algorithm that can be used as a guide. For patients less than 10 years of age, the options are topical corsticosteroids, topical minoxidil, and anthralin. For adults with less than 50% scalp involvement, the first option is usually the use of intralesional corticosteroids, followed by topical corticosteroid creams, minoxidil solution, or anthralin cream. For adults with more than 50% scalp involvement, topical immunotherapy and phototherapy are added to the other options. Other modalities such as cyclosporine, tacrolimus, interferon, dapsone, and cosmetic coverups are also discussed.

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mentioning

confidence: 56%

The treatment of alopecia areata

Bolduc

Shapiro²

2001

Dermatol Ther

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“…However, only two placebo-controlled studies with very small numbers of patients reported a treatment response [51,52], but these studies have not been confirmed by others [53][54][55][56], and studies with appropriate numbers of patients or half side treatment have never been performed. From our personal experience topically applied corticosteroids did not lead to hair regrowth.…”

Section: Topical Corticosteroidsmentioning

confidence: 98%

Current and Potential Agents for the Treatment of Alopecia Areata>

Freyschmidt‐Paul

Hoffmann²,

Levin³

et al. 2001

CPD

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Alopecia areata is considered to be a T-cell mediated autoimmune disease of the hair follicle. Current immunosuppressive approaches and immunomodulatory treatment with contact sensitizers such as diphenylcyclopropenone and squaric acid dibutylester are dealt with in this review article. The efficacy of the various modes of treatment is evaluated by a review of literature and their mode of action is discussed. In accordance with the mechanism of autoimmune pathogenesis of AA, improved future treatments may be immunosuppressive or immunomodulatory, or they should otherwise protect the hair follicle from the injurious effects of the inflammation. Such possible future therapeutic approaches include the use of liposomes as an improved vehicle, application of immunosuppressive cytokines like TGF-beta and IL-10, inhibition of apoptosis mediated by the Fas-FasL system, inhibition of the lymphocyte homing receptor CD44v10, induction of tolerance as well as principles of gene therapy.

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“…My own experience with betamethasone dipropionate cream in the nonoptimized vehicle (Diprosone) parallels that of Pascher et al 8 Using the cream twice daily without occlusion seems to work particularly well in children (even in some with 100% hair loss); it can also be beneficial in adults. For individuals with wide¬ spread or actively flaring disease, treatment of the en¬ tire scalp seems to be most effective to elicit and main¬ tain cosmetically adequate hair growth.…”

mentioning

confidence: 62%

Alopecia Areata

Fiedler¹

1992

Arch Dermatol

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Although it is clear from the foregoing that some of the drugs and chemicals used to treat severe alopecia areata are efficacious to some degree, it is impossible to draw any meaningful comparisons among the data outlined in Tables 1 and 2. Virtually all of the studies were designed differently. Differences in chronicity and extent of disease as well as history of previous treatment resistance may significantly affect efficacy data even as two investigators compare the same drug. Drug-induced hair regrowth in alopecia areata may be very slow; a cosmetic response may take 1 to 2 years to achieve. Efficacy determinations made at shorter intervals may, therefore, not reflect true therapeutic potential. Efficacy end points vary significantly and need to be standardized. From a practical standpoint, scalp hair coverage that is deemed by the patient to be cosmetically acceptable seems to be a reasonable efficacy end point to report. Maintenance of cosmetic effect with continued treatment and/or following discontinuation of treatment also is useful to document. Table 3 outlines my approach to therapy of alopecia areata. Topical treatments often must be used for as long as 3 months before evidence of regrowth can be seen. In my experience with severe disease, if topical treatments cannot control a flare or induce regrowth, then the patient will often require either lengthy or frequent courses of systemic steroids. In my experience, prednisone doses as low as 20 mg/d may be associated with aseptic neurosis of the hip or severe gastrointestinal bleeding. Severe alopecia areata is a disease for which all therapies are, at best, palliative and, at worst, potentially harmful to patients who are usually otherwise very healthy. The psychosocial significance of this disease is enormous. The insights shared by a long-time sufferer of the disease mirror those expressed by the many patients with whom I have worked during the past 12 years. Three key elements to effectively treat the patient are (1) to help the patient understand the disease; (2) to encourage the patient to share his or her feelings with the physician, family, friends, and other sufferers of the disease; and (3) to help the patient to maintain a sense of hope for future scientific knowledge and treatment of the disease. With a thorough knowledge of the potential benefits and risks of each treatment or combination treatment, the physician with the patient's understanding and cooperation may then embark on what may be in severe cases a lengthy and sometimes unproductive therapeutic process.

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Assay of 0.2 % Fluocinolone Acetonide Cream for Alopecia Areata and Totalis

Cited by 67 publications

References 6 publications

The treatment of alopecia areata

The treatment of alopecia areata

Current and Potential Agents for the Treatment of Alopecia Areata>

Alopecia Areata

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