Fiedler V C, Wendrow A, Szpunar G J, Metzler C, DeVillez R L
Dermatology Unit, Upjohn Co, Kalamazoo, MI 49007.
Arch Dermatol. 1990 Jun;126(6):756-9. doi: 10.1001/archderm.126.6.756.
Combination therapy with 5% minoxidil plus 0.5% anthralin was used to treat 51 patients with severe treatment-resistant alopecia areata. History of a cosmetically inadequate response to one or both drugs used as a single agent was present in 50 of the 51 patients. Therapy was relatively well tolerated except by 1 patient who developed a severe irritant reaction and was dropped from the study. Mild to moderate irritant dermatitis was seen in all remaining patients. Cosmetic response was seen in 5 (11%) of 45 patients who completed the 6-month study. Cosmetic response was maintained in 4 (80%) of 5 patients who continued treatment for as long as 84 weeks. All responders had evidence of hair regrowth by week 12. The rapidity and extent of hair regrowth were greater with combination therapy than with either drug used as a single agent. Serum and 24-hour urinary minoxidil determinations showed enhanced systemic minoxidil absorption, which was probably secondary to the irritant dermatitis in some patients; however, no clinical evidence of a systemic minoxidil effect was found. These data suggest that combination therapy using drugs with probable different mechanisms of action may provide a synergistic effect in alopecia areata.
采用5%米诺地尔加0.5%蒽林联合治疗51例重度难治性斑秃患者。51例患者中有50例曾对单独使用的一种或两种药物出现美容效果不佳的情况。除1例出现严重刺激性反应并退出研究的患者外，治疗的耐受性相对良好。其余所有患者均出现轻至中度刺激性皮炎。45例完成6个月研究的患者中有5例（11%）出现美容效果。5例继续治疗长达84周的患者中有4例（80%）美容效果得以维持。所有有反应者在第12周时均有毛发再生迹象。联合治疗的毛发再生速度和程度均高于单独使用任一药物。血清和24小时尿米诺地尔测定显示全身米诺地尔吸收增强，这可能继发于部分患者的刺激性皮炎；然而，未发现米诺地尔全身效应的临床证据。这些数据表明，使用可能具有不同作用机制的药物进行联合治疗可能在斑秃中产生协同效应。
