Elazig Education and Research Hospital Department of Dermatology, TR23119 Elazig, TurkeyFirat University Faculty of Medicine, Departments of Dermatology.
J Eur Acad Dermatol Venereol. 2014 Jan;28(1):34-40. doi: 10.1111/jdv.12043. Epub 2012 Nov 26.
Alopecia areata (AA) is an organ-specific, T-cell-mediated autoimmune disease that is characterized by non-scarring hair loss.
We aimed to find the factors that may affect the response to topical therapy in AA.
The study included a total of 60 patients with AA and 30 healthy control patients. The AA patients were randomized into two groups. 40 patients used 0.05% clobetasol propionate cream, and 20 patients used petrolatum (placebo). Both groups applied topical treatments to their lesions twice daily for 12 weeks.
The mean extent of AA was 21.88 ± 16.75% in patients with autoantibodies and 12.16 ± 13.55% in those who were negative for autoantibodies (P = 0.021). Ophiasic pattern and nail involvement were observed more frequently in patients with atopy (P < 0.05). Relapse was more frequent in patients with atopy (P = 0.002) and nail involvement (P = 0.02).
We observed that the presence of autoantibodies was associated with more extensive AA, and that ophiasic hair loss pattern and nail dystrophy were significantly associated with atopy. Topical clobetasol propionate treatment produced a modest advantage in hair regrowth as compared with placebo. Notably, atopic AA patients have a higher risk of relapse and redevelopment of AA after completing a course of topical corticosteroid treatment.
斑秃（AA）是一种器官特异性、T 细胞介导的自身免疫性疾病，其特征是无瘢痕性脱发。
我们旨在寻找可能影响 AA 局部治疗反应的因素。
本研究共纳入 60 例 AA 患者和 30 例健康对照患者。AA 患者随机分为两组。40 例患者使用 0.05%丙酸氯倍他索乳膏，20 例患者使用凡士林（安慰剂）。两组患者均每日两次将局部治疗药物涂抹于皮损处，共 12 周。
自身抗体阳性患者 AA 的平均严重程度为 21.88±16.75%，自身抗体阴性患者 AA 的严重程度为 12.16±13.55%（P=0.021）。特应性患者中更常观察到蛇形发和甲受累（P<0.05）。特应性患者（P=0.002）和甲受累患者（P=0.02）更易复发。
我们发现自身抗体的存在与 AA 更广泛有关，蛇形脱发模式和甲营养不良与特应性显著相关。与安慰剂相比，外用氯倍他索丙酸酯治疗在毛发生长方面有适度优势。值得注意的是，特应性 AA 患者在完成局部皮质类固醇治疗后，复发和 AA 再次发生的风险更高。
