scholarly journals Superficial Cryotherapy Versus Intralesional Corticosteroid Injection In Alopecia Areata: A Comparative Clinical And Dermoscopic Study

2022 ◽  
Vol 86 (1) ◽  
pp. 211-217
Author(s):  
Afaf Ibrahiem Ahmad Mohammed ◽  
Asmaa Saied Farag ◽  
Hala S.A. Hafiz
QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
M A Abdallah ◽  
M Y Soltan ◽  
R S Mohammed

Abstract Background Alopecia areata (AA) is a common, inflammatory, non-scarring type of hair loss. Although hair loss can affect all hair bearing sites, patchy alopecia affecting the scalp is the most common type. Hair loss may progress to alopecia totalis (AT) which is complete balding at the scalp, or to alopecia universalis (AU), describing loss of all hairs on the scalp and body. Consequently, this can cause a devastating emotions effects on patients and may be expose them to psychological comorbidities such as depression, anxiety and social phobia. Objectives To assess the efficacy and safety of intradermal delivery of minoxidil 5% alone and in combination with intralesional triamcinolone acetonide for treatment of alopecia areata. Patients and Methods This study is prospective randomized intra-patients comparative control clinical trail that include 20 Egyptian patients suffering from multiple patches of AA during December 2017 till November 2018 which approved by The Dermatology Research Ethical Committee, Faculty of Medicine, Ain Shams University. Each patient had at least 5 scalp patches of approximately similar size (minimally 3 cm2) with a severity of alopecia tool (SALT) score up to S2 (less than 50% of scalp involvement) either in stable or progressive course. Patients were recruited from outpatient clinic of Dermatology, Ain Shams University Hospital and Al-houd Al-marsoud Hospital and informed written consent was obtained from all of them after explanations the study objective before enrollment in it. Results Considering the side effects of the treatment, all patients in all groups develop different types of side effects only the intolerable pain of injection was common between them and it was statistically not significant in comparison between the treatment groups. All the treatment groups showed significant reduction in dermoscopic finding of AA after treatment except in control group. Conclusion Standard intralesional corticosteroids are the mainstay first line treatment of patchy alopecia that involving less than 50% of the scalp and for cosmetics areas such as beard and eyebrows.


2021 ◽  
Vol 2 (2) ◽  
pp. 41-54
Author(s):  
Ru Wang ◽  
Patricia L. Danielsen ◽  
Magnus S. Ågren ◽  
Janine Duke ◽  
Fiona Wood ◽  
...  

Keloid scars are difficult to manage and remain a therapeutic challenge. Corticosteroid therapy alone or ionising radiation (radiotherapy) alone or combined with surgery are first-line treatments, but the scientific justification for these treatments is unclear. The aim of this systematic review and meta-analysis of randomised controlled trials (RCTs) is to assess the effects of intralesional corticosteroid injection in treating keloids or preventing their recurrence after surgical removal. Searches for RCTs were conducted through the MEDLINE, EMBASE, EBSCO and Cochrane databases from January 1974 to September 2017. Two authors independently reviewed study eligibility, extracted data, analysed the results, and assessed methodological quality. Sixteen RCTs that included more than 814 patients were scrutinised. The quality of evidence for most outcomes was moderate to high. In 10 RCTs, corticosteroid intralesional injections were compared with 5-fluorouracil, etanercept, cryosurgery, botulinum toxin, topical corticosteroid under a silicone dressing, and radiotherapy. Corticosteroid intralesional injections were more effective than radiotherapy (RR 3.3, 95% CI: 1.4–8.1) but equipotent with the other interventions. In conjunction with keloid excision, corticosteroid treatment was compared with radiotherapy, interferon α-2b and verapamil. In two RCTs, there were fewer keloid recurrences (RR 0.43, 95% CI: 0.21–0.89) demonstrated with adjuvant radiotherapy than with corticosteroid injections. More high-quality, large-scale RCTs are required to establish the effectiveness of corticosteroids and other therapies in keloid management.


2019 ◽  
Vol 11 (3) ◽  
pp. 249-255 ◽  
Author(s):  
Thanapon Sutharaphan ◽  
Kumutnart Chanprapaph ◽  
Vasanop Vachiramon

Cheilitis granulomatosa (CG) is a rare idiopathic condition with painless lip swelling, characterized by non-necrotizing granulomatous inflammation in the absence of other identifiable causes such as Crohn’s disease, sarcoidosis, foreign body reaction, or infection. CG may precede the presentation of Crohn’s disease after long-term follow-up. Spontaneous remission of CG rarely occurs. To date, given the rarity of CG, there is no gold standard treatment. Recommended treatments are supported by small studies, case reports/series, and expert opinions. Glucocorticoids are the first-line therapy in the acute stages of the disease; however, recurrence commonly occurs. Previously, methotrexate (MTX) showed a beneficial effect on orofacial swelling in a case of CG accompanied by Crohn’s disease. We present a patient with CG without Crohn’s disease. He was treated with oral MTX in combination with intralesional corticosteroid injection on one side of the lip. The injected side showed improvement, while lip swelling on the noninjected area remained unchanged after 3 months of treatment. Therefore, CG is refractory to treatment with MTX from our experience. Further studies regarding the optimum dosage of MTX is needed.


2017 ◽  
Vol 44 (11) ◽  
pp. e304-e305 ◽  
Author(s):  
Taisuke Ito ◽  
Takashi Yoshimasu ◽  
Fukumi Furukawa ◽  
Motonobu Nakamura ◽  
Yoshiki Tokura

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