Majid Imran, Jeelani Shazia, Imran Saher
CUTIS Institute of Dermatology, Srinagar, India.
Department of Dermatology, Jammu and Kashmir Health Services, Jammu and Kashmir, India.
J Cutan Aesthet Surg. 2018 Oct-Dec;11(4):217-221. doi: 10.4103/JCAS.JCAS_96_18.
Intradermal steroid injections are used as treatment option in resistant alopecia areata. However, it is difficult and quite painful to treat large areas of alopecia with this modality.
To assess the efficacy and safety profile of a combination of fractional carbon dioxide (CO) treatment followed by topical corticosteroid application in resistant alopecia areata.
Ten cases of resistant alopecia areata who had not responded to multiple treatment modalities were treated with fractional CO laser followed by topical application of triamcinolone spray (10mg/mL) on the resistant lesions. Patients received 4-8 sessions that were repeated at an interval of 3-4 weeks. Response to treatment was assessed on a quartile physician assessment scale and labeled as excellent (>75% regrowth), good (50%-75% regrowth), fair (26%-50% response), and poor (<25% regrowth).
Eight of these ten cases completed the treatment process. Seven of these eight patients had complete recovery of the area treated. One patient however did not show good response even after four sessions. No significant adverse effects were noted in any of the patients.
Fractional CO laser in combination with topical triamcinolone can prove to be an effective treatment option in resistant alopecia areata.
皮内注射类固醇是治疗顽固性斑秃的一种选择。然而，用这种方式治疗大面积斑秃既困难又相当痛苦。
评估分次二氧化碳（CO）治疗联合局部应用皮质类固醇治疗顽固性斑秃的疗效和安全性。
10例对多种治疗方式均无反应的顽固性斑秃患者接受了分次CO激光治疗，随后在顽固性皮损上局部应用曲安奈德喷雾剂（10mg/mL）。患者接受4 - 8次治疗，每隔3 - 4周重复一次。根据四分位医生评估量表评估治疗反应，并标记为优秀（再生>75%）、良好（再生50% - 75%）、中等（反应26% - 50%）和差（再生<25%）。
这10例患者中有8例完成了治疗过程。这8例患者中有7例治疗区域完全恢复。然而，1例患者即使在4次治疗后也未显示出良好反应。所有患者均未观察到明显不良反应。
分次CO激光联合局部曲安奈德可被证明是治疗顽固性斑秃的一种有效治疗选择。
