Trichoscopy as an evaluation method for alopecia areata treatment: A comparative study

Abstract

Alopecia areata (AA) is an extremely common form of nonscarring hair loss, with a calculated lifetime risk of 2%. It affects both sexes and has no racial predilection, and it represents a significant healthcare burden. 1 Despite the high prevalence, there are no evidence-based treatments for AA. 2 Recent research has uncovered new insights into the etiopathogenesis of AA, which opened the door to the development of new treatment options. 3 Lacarrubba and colleagues first described the trichoscopic features of AA in 2004. Since then, numerous studies showed interest in studying the role of trichoscopy in the diagnosis, assessment of disease activity, severity, prognosis, and therapeutic monitoring of AA. 4,5 Treatment by intralesional corticosteroids (ILCs) remains a standard of care in adults with limited patchy AA. 6-8 However, success rates vary, and local cutaneous atrophy and telangiectasia are common adverse effects. 9Platelet-rich plasma (PRP) has gained much ground, in several medical fields including dermatology and plastic surgery, because of its ability to promote wound healing, 10 its skin rejuvenating effects, 11 and its ability to promote hair growth. 12,13

Platelet Rich Plasma and Its Use in Hair Regrowth: A Review

“…One study found that final severity of alopecia tool (SALT) score showed significant lower levels in both groups compared to baseline levels (P = 0.025 and P = 0.008) with no significant difference between both treatment modalities in term of clinical improvement, while final alopecia areata symptom impact scale (AASIS) showed significant decrease in PRP group (P = 0.006) but not in triamcinolone group (P = 0.062). 62 Similar results were found in the other study by showing that there was no statistically significant difference in SALT score reduction and hair regrowth scale between these two groups. 63…”

“… 61 Collectively, many randomized controlled trials demonstrated that treatment with PRP can stimulate hair regrowth to the same extent as intralesional injection of triamcinolone acetonide in the treatment of AA. 62–65 Two recent studies compared the therapeutic effect of intralesional injections of PRP with triamcinolone acetonide in AA. One study found that final severity of alopecia tool (SALT) score showed significant lower levels in both groups compared to baseline levels (P = 0.025 and P = 0.008) with no significant difference between both treatment modalities in term of clinical improvement, while final alopecia areata symptom impact scale (AASIS) showed significant decrease in PRP group (P = 0.006) but not in triamcinolone group (P = 0.062).…”

Low Level Laser versus Platelet-rich Plasma in Treatment of Alopecia Areata: A Randomized Controlled Intra-patient Comparative Study

“…In literature there are few clinical trials discussing treatment of AA with PRP [9], [16], [17], [18], [19], [20], [21], [22], [23], [23], [24], [25], [26], [27], [28], [29], [30], [31], [32], [33], [34], [35] and most of them agree with our results. On the other hand, D'Ovidio and Roberto in 2014 showed restricted usefulness of PRP in long standing cases (more than 2 years) and proposed that PRP effect may be held in reserve for mild cases [44].…”

“…These GFs are believed to stimulate stem cells sited in HF at the bulge areas leading to growth of fresh follicles and enhancing angiogenesis [13], [15]. Despite of its promising results in AA, a paucity of randomized controlled clinical trials had been published to assess the efficiency of PRP in management of AA [9], [13], [16], [17], [18], [19], [20], [21], [22], [23], [24], [25], [26], [27], [28], 29], [30], [31], [32], [33], [34], [35]. Photobiomodulation (PBM), or low-level laser (or) light therapy (LLLT) is using red light (600-700 nm) or near infrared (700 nm-1000+nm) which is obtained from 5 to 500 mW light-emitting diode (LED) source [36], [37].…”

Characterizing the relationships between patient‐reported outcomes and clinician assessments of alopecia areata in a phase 2a randomized trial of ritlecitinib and brepocitinib

“…6 To our knowledge, there are only two other interventional trials that have reported AASIS data, but these studies did not report correlations with SALT scores. 11,12 The mean improvements in AASIS scores observed in the active treatment groups at week 24 ranged from À0.3 to À3.7 on the 0-10 point AASIS scoring system. The AASIS items with the greatest improvement in both active treatment groups were the 2 items in the hair loss subscale ('Scalp hair loss' and 'Body or eyelashes hair loss', mean changes: À2.3 to À3.7), which reflects the significant clinician-assessed hair regrowth previously reported.…”