Waśkiel-Burnat Anna, Rakowska Adriana, Sikora Mariusz, Olszewska Małgorzata, Rudnicka Lidia
Department of Dermatology, Medical University of Warsaw, Warsaw, Poland.
J Cosmet Dermatol. 2020 Mar;19(3):746-751. doi: 10.1111/jocd.13064. Epub 2019 Jul 13.
There are no evidence-based data how to predict response to therapy in patients with alopecia areata.
The assessment of the predictive value of trichoscopy for the therapeutic outcome in patients with alopecia areata.
A total of 65 patients with patchy alopecia areata were included into the study. Trichoscopy was performed at baseline and 2 months after the treatment initiation. After 6 months, patients were classified as responders (27/65) and nonresponders (38/65).
There were no differences between the groups in baseline trichoscopy. After 2 months, black dots, broken hairs, exclamation mark hairs, and tapered hairs occurred significantly more often in nonresponders compared to responders (19/38, 50% vs 3/27, 11%; 26/38, 68% vs 6/27, 22%; 23/38, 61% vs 5/27, 19% and 11/38, 29% vs 0/27, 0%, respectively). Upright regrowing hairs and pigtail hairs occurred significantly more often in responders compared to nonresponders (27/27, 100% vs 21/38, 55% and 9/27, 33% vs 3/38, 8%, respectively). A trichoscopy-based Alopecia Areata Predictive Score (min -4 to max 2) was developed. Probability of hair regrowth was 98.3%, 88.7%, 52.3%, 13.2%, 2.1%, 0.3%, and 0% in patients with score 2, 1, 0, -1, -2, -3, and -4, respectively.
In patchy alopecia areata, upright regrowing hairs and pigtail hairs are positive, while black dots, broken hairs, exclamation mark hairs, and tapered hairs negative predictive markers. Alopecia Areata Predictive Score is new trichoscopy-based tool to predict treatment outcome in patients with patchy alopecia areata.
目前尚无基于证据的数据可用于预测斑秃患者对治疗的反应。
评估毛囊镜检查对斑秃患者治疗效果的预测价值。
共有65例斑秃患者纳入本研究。在基线期和开始治疗2个月后进行毛囊镜检查。6个月后，将患者分为反应者（27/65）和无反应者（38/65）。
两组在基线毛囊镜检查方面无差异。治疗2个月后，与反应者相比，无反应者中黑点、断发、惊叹号样发和锥形发出现的频率显著更高（分别为19/38，50% 对3/27，11%；26/38，68% 对6/27，22%；23/3, 61% 对5/27，19%；11/38，29% 对0/27，0%）。与无反应者相比，反应者中直立生长的毛发和辫子样发出现的频率显著更高（分别为27/27，100% 对21/38，55%；9/27，33% 对3/38，8%）。开发了一种基于毛囊镜检查的斑秃预测评分（最小值 -4至最大值2）。评分分别为2、1、0、-1、-2、-3和-4的患者毛发再生的概率分别为98.3%、88.7%、52.3%、13.2%、2.1%、0.3%和0%。
在斑秃患者中，直立生长的毛发和辫子样发是阳性预测指标，而黑点、断发、惊叹号样发和锥形发是阴性预测指标。斑秃预测评分是一种基于毛囊镜检查的新工具，用于预测斑秃患者的治疗效果。
