Sharma Aseem, Chouhan Kavish, Bhatia Satish, Dashore Shuken
Chief Dermatologist, Skin Saga Centre for Dermatology, Mumbai, Maharashtra, India.
Director and Consultant Dermatologist, DERMACLINIX, New Delhi, India.
Indian Dermatol Online J. 2021 Nov 25;12(Suppl 1):S31-S40. doi: 10.4103/idoj.idoj_328_21. eCollection 2021 Nov.
The goal of these recommendations is to provide a framework to practitioners for implementing useful, evidence-based recommendations for the preparation of platelet-rich plasma (PRP) and its use in androgenetic alopecia (AGA). The Indian Association of Dermatologists, Venereologists and Leprologists (IADVL) assigned the task of preparing these recommendations to its taskforce on PRP. A comprehensive literature search was done in the English language on the PRP across multiple databases. The grade of evidence and strength of recommendation were evaluated on the GRADE (Grading of Recommendation, Assessment, Development, and Evaluation) framework. A draft of clinical recommendations was developed on the best available evidence, which was also scrutinized and critically evaluated by the IADVL Academy of Dermatology. Based on the inputs received, the final consensus statement was prepared. A total of 30 articles (meta-analyses, prospective and retrospective studies, reviews [including chapters in books], and case series) were critically evaluated, and the evidence thus gathered was used in the preparation of these recommendations. This expert group recommends use of manual double-spin method for the preparation of PRP for AGA. Minimum three to five sessions of PRP are recommended for AGA with a gap of 1 month between the two sessions. Patients with Grade II to V Norwood Hamilton classification of AGA are the ideal subset for PRP. A total of 5 to 7 mL of PRP and 0.05 to 0.1 mL/cm is the recommended dose of PRP for AGA. Activation of PRP is not required when it is used for AGA. About 1 to 1.5 million platelets/μL of platelets in PRP is the recommended platelet concentration in PRP for the treatment of AGA. I-PRF (injectable platelet-rich fibrin) has also been found to be useful in AGA, although further studies are required to establish its role. PRP can also have an adjunctive role in hair transplantation procedures.
这些建议的目的是为从业者提供一个框架，以便实施关于制备富血小板血浆（PRP）及其在雄激素性脱发（AGA）中应用的实用、循证建议。印度皮肤科医生、性病学家和麻风病学家协会（IADVL）将编写这些建议的任务分配给了其PRP特别工作组。对多个数据库中关于PRP的英文文献进行了全面检索。根据GRADE（推荐分级、评估、制定和评价）框架对证据等级和推荐强度进行了评估。基于可得的最佳证据制定了临床建议草案，该草案也由IADVL皮肤病学学会进行了审查和严格评估。根据收到的意见，编写了最终的共识声明。共对30篇文章（荟萃分析、前瞻性和回顾性研究、综述[包括书籍章节]和病例系列）进行了严格评估，并将由此收集的证据用于编写这些建议。该专家组建议采用手工双离心法制备用于AGA的PRP。建议对AGA进行至少三至五次PRP治疗，两次治疗之间间隔1个月。AGA诺伍德-汉密尔顿分级为II至V级的患者是PRP的理想适用人群。用于AGA的PRP推荐剂量为总量5至7 mL，每平方厘米0.05至0.1 mL。PRP用于AGA时无需激活。用于治疗AGA的PRP中推荐的血小板浓度为每微升约100万至150万个血小板。尽管需要进一步研究来确定其作用，但已发现可注射富血小板纤维蛋白（I-PRF）在AGA中也有用。PRP在毛发移植手术中也可发挥辅助作用。
