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斑秃治疗共识 - 巴西皮肤病学会

Consensus on the treatment of alopecia areata - Brazilian Society of Dermatology.

作者信息

Ramos Paulo Müller, Anzai Alessandra, Duque-Estrada Bruna, Melo Daniel Fernandes, Sternberg Flavia, Santos Leopoldo Duailibe Nogueira, Alves Lorena Dourado, Mulinari-Brenner Fabiane

机构信息

Department of Dermatology and Radiotherapy, Universidade Estadual Paulista, Botucatu, SP, Brazil.

Department of Dermatology, Universidade de São Paulo, São Paulo, SP, Brazil.

出版信息

An Bras Dermatol. 2020 Nov-Dec;95 Suppl 1(Suppl 1):39-52. doi: 10.1016/j.abd.2020.05.006. Epub 2020 Oct 8.

Abstract

BACKGROUND

Alopecia areata is a highly frequent disease with an impact on quality of life and several treatment options with little clinical confirmatory evidence.

OBJECTIVE

To disseminate the recommendations of Brazilian dermatologists with expertise in the treatment of alopecia areata.

METHODS

Eight specialists with expertise in alopecia areata from different university centers were appointed by the Brazilian Society of Dermatology to reach a consensus on its treatment. Based on the adapted DELPHI methodology, the relevant elements were considered; then, an analysis of recent literature was carried out and the consensus was written down. Consensus on the management of alopecia areata was defined with the approval of at least 70% of the panel.

RESULTS/CONCLUSIONS: Intralesional injectable corticotherapy was considered the first option for localized disease in adults. In extensive cases with signs of activity, systemic corticosteroid therapy should be considered and can be used together with immunosuppressants (corticosteroid-sparing agents). The use of an immunosensitizer (diphencyprone) is an option for stable long-term cases. Evaluation of side effects is as important as the rate of hair regrowth.

摘要

背景

斑秃是一种常见疾病,会影响生活质量,且有多种治疗方案,但临床确证证据较少。

目的

传播巴西在斑秃治疗方面具有专业知识的皮肤科医生的建议。

方法

巴西皮肤病学会指定了八位来自不同大学中心的斑秃治疗专家,就其治疗达成共识。基于改良的德尔菲方法,考虑了相关因素;然后,对近期文献进行了分析并形成了共识。斑秃管理的共识需经至少70%的专家小组批准。

结果/结论:皮损内注射皮质类固醇疗法被认为是成人局限性疾病的首选。在有活动迹象的广泛性病例中,应考虑全身皮质类固醇疗法,且可与免疫抑制剂(皮质类固醇节省剂)联合使用。免疫致敏剂(二苯环丙烯酮)的使用是稳定长期病例的一种选择。副作用评估与毛发生长率同样重要。

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