Abstract:
Background: Alopecia areata (AA) is a common form of non-scarring hair loss of
scalp and/or body. Genetic predisposition, autoimmunity, and environmental factors
play a major role in the etiopathogenesis of AA. Patchy AA is the most common
form. Alopecia areata (AA) is considered as a T-cell infiltrated autoimmune disorder.
The 308-nm excimer laser is thought to be capable of inducing T-cell apoptosis in
vitro, suggesting that the 308-nm excimer lamp (not laser) might be effective for the
treatment of AA. Several topical corticosteroids with varying levels of efficacy have
been used to treat alopecia areata.
Objectives: Objective of this study is to compare the efficacy of 308-nm excimer
lamp vs. topical micronized fluticasone propionate 0.05% cream in the treatment of
alopecia areata.
Materials and method: Twenty five patients with two or more comparable patches
of alopecia areata (AA) were recruited into the study. One patch was treated with
308nm excimer lamp twice weekly (test patch) and other patch with topical
micronized fluticasone propionate 0.05% cream twice daily (control patch). The total
duration of treatment was for three months and a monthly follow up for three months.
Baseline clinical images and dermoscopic images were taken. After the end of
therapy, clinical and dermoscopic images were taken during the follow up period of
monthy three months to assess hair regrowth. The 2 primary efficacy parameters
assessed were: Increase from baseline hair count at 12 weeks and hair regrowth score
on six point scale at 12 weeks and during the follow up. Two blinded investigators
evaluated response on computer screen using dermoscopic images.
Results: (1) Hair counts – The mean increase in hair count at week 12 was
significantly greater for the study group compared to the control group. (2) Hair
X
regrowth score – In the study group, hair regrowth was started at 4th session onwards
with score of 3-4 and whereas in control group hair regrowth was started at 14th
session onwards with score of 1-3.
Conclusion: The results of this study did not establish “topical fluticasone cream” as
a unique therapeutic modality for AA. The results with “excimer therapy” indicated
that this therapy induces effective hair regrowth within short duration without any
serious side effect for treating AA. However, the total number and frequency of
sessions and long-term sustainability of response of excimer therapy need to be
evaluated within a larger population.
