Wu Sean Z, Wang Sophie, Ratnaparkhi Rubina, Bergfeld Wilma F
Department of Dermatology, University of Cincinnati, Cincinnati, Ohio.
School of Medicine, Case Western Reserve University, Cleveland, Ohio.
Pediatr Dermatol. 2018 Nov;35(6):817-820. doi: 10.1111/pde.13703. Epub 2018 Oct 18.
BACKGROUND/OBJECTIVES: Data on treatment options in pediatric alopecia areata are limited. Topical anthralin has been demonstrated to be an effective treatment option in adults and has minimal systemic toxicity. Prior results on its efficacy in children with alopecia areata have been mixed.
Medical records of 37 patients with alopecia areata who were started on topical anthralin before age 17 were reviewed for efficacy and safety data. Scalp regrowth was quantified by serial photography if available or by medical record documentation if photographs were unavailable. Mean duration of clinical follow-up was 2.5 years.
Most patients were started on anthralin while continued on prior therapies, including topical corticosteroids, minoxidil, and/or intralesional corticosteroids. Twelve patients (32%) experienced complete scalp regrowth, while 25 patients (68%) experienced at least 50% maximal scalp regrowth with using anthralin. Of the patients with at least 50% scalp regrowth, mean time to first clinically observed response was 3.4 months. Mean time to maximal response was 15 months. Four patients stopped anthralin due to skin irritation. Relapses affected 64% of those with at least 50% maximal scalp regrowth.
Topical anthralin provides children with alopecia areata an additional option that offers potential for significant scalp regrowth with minimal systemic effects. Treatment course may need to be continued for at least 1 year in order to achieve maximal efficacy. The efficacy of anthralin may be limited by high rate of recurrence and local adverse effects.
背景/目的：儿童斑秃治疗方案的数据有限。外用蒽林已被证明是成人的一种有效治疗选择，且全身毒性极小。此前关于其对儿童斑秃疗效的结果不一。
回顾了37例17岁前开始外用蒽林治疗的斑秃患者的病历，以获取疗效和安全性数据。如有可用的连续照片，则通过其对头皮再生长情况进行量化；若没有照片，则通过病历记录。临床随访的平均时长为2.5年。
大多数患者在继续使用包括外用皮质类固醇、米诺地尔和/或病灶内注射皮质类固醇等先前疗法的同时开始使用蒽林。12例患者（32%）实现了头皮完全再生长，而25例患者（68%）在使用蒽林后实现了至少50%的最大头皮再生长。在至少有50%头皮再生长的患者中，首次临床观察到反应的平均时间为3.4个月。达到最大反应的平均时间为15个月。4例患者因皮肤刺激而停用蒽林。复发影响了至少有50%最大头皮再生长患者中的64%。
外用蒽林为儿童斑秃提供了另一种选择，有可能在全身影响最小的情况下实现显著的头皮再生长。可能需要持续治疗至少1年才能达到最大疗效。蒽林的疗效可能受到高复发率和局部不良反应的限制。
