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Intramuscular triamcinolone acetonide: An undervalued option for refractory alopecia areata

Authors
 Jimyung Seo  ;  Young In Lee  ;  Shinwon Hwang  ;  Zhenlong Zheng  ;  Do Young Kim 
Citation
 JOURNAL OF DERMATOLOGY, Vol.44(2) : 173-179, 2017-02 
Journal Title
JOURNAL OF DERMATOLOGY
ISSN
 0385-2407 
Issue Date
2017-02
MeSH
Adolescent ; Adult ; Alopecia Areata / drug therapy* ; Child ; Female ; Glucocorticoids / administration & dosage* ; Humans ; Injections, Intramuscular ; Male ; Middle Aged ; Retrospective Studies ; Triamcinolone Acetonide / administration & dosage* ; Young Adult
Keywords
adverse effects ; alopecia areata ; intramuscular triamcinolone acetonide ; relapse ; steroids
Abstract
Severe alopecia areata (AA) can have an unpredictable clinical course and become refractory to contact immunotherapy. Novel treatment options include low-dose interleukin-2 and Janus kinase inhibitors; however, these treatments are still under investigation. Therefore, we evaluated the efficacy and safety of intramuscular (i.m.) triamcinolone acetonide (TAC) as a rescue therapy for refractory AA. We retrospectively analysed efficacy, adverse effects and relapse rate of i.m. TAC monthly in 27 patients with refractory AA. We defined AA as refractory if the patient showed an unsatisfactory response to both systemic treatment (not i.m. TAC) and the consecutive diphenylcyclopropenone immunotherapy. The initial systemic treatment of other forms of corticosteroids and/or cyclosporin was used to control extensive AA involving more than 25% of the scalp. Administration of i.m. TAC for 3-6 months resulted in a 63.0% response rate, and all patients showed inactive disease after treatment. Final hair regrowth negatively correlated with initial scalp involvement (Spearman r = -0.595, P = 0.001). All patients showed complete recovery of adrenocortical reserve within 3 months after the last injection. Adverse effects of systemic steroid therapy were observed only in female patients (dysmenorrhea and osteoporosis). i.m. TAC may provide a valuable therapeutic option to manage active hair loss and facilitate hair regrowth in refractory AA, especially in male patients.
Full Text
https://onlinelibrary.wiley.com/doi/10.1111/1346-8138.13533
DOI
10.1111/1346-8138.13533
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Dermatology (피부과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Biomedical Systems Informatics (의생명시스템정보학교실) > 1. Journal Papers
Yonsei Authors
Kim, Do Young(김도영) ORCID logo https://orcid.org/0000-0002-0194-9854
Lee, Young In(이영인) ORCID logo https://orcid.org/0000-0001-6831-7379
Hwang, Shinwon(황신원) ORCID logo https://orcid.org/0000-0002-0202-7800
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/183001
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