Evaluation of intralesional triamcinolone acetonide treatment and platelet-rich plasma (PRP) treatment in patients diagnosed with Alopecia areata

ABSTRACT Introduction and Objective: Alopecia areata (AA) is a common chronic non-scarring autoimmune disease that causes hair loss, affecting up to 2% of the general population. There are various local and systemic treatments for alopecia areata. Recently, Platelet Rich Plasma (PRP) has been used more frequently in the treatment. In our study, we aimed to evaluate the efficacy of intralesional triamcinolone acetonide and platelet rich plasma (PRP) treatment in patients with Alopecia areata and to compare the efficacy of the two methods. Materials and methods: Patients with patch type alopecia areata who applied to Yüzüncü Yıl University Faculty of Medicine, Dermatology Outpatient Clinic between 27.03.2024 and 27.03.2025 participated in our study. The age range of our patients was 18-65 years and they had not received treatment for alopecia areata before. We divided the patients into 2 groups. The first group received 3 sessions of PRP treatment every 4 weeks. The second group received 3 sessions of intralesional triamcinolone acetonide treatment every 4 weeks. The scalp photos of the 2 groups were taken at the beginning, 3rd month and 6th month, and the severity of alopecia tool (SALT, alopecia score severity) was calculated and compared statistically. The effects of age, gender, disease duration and family history on response to treatment were investigated and compared. Results: A total of 60 patients with alopecia areata, 41 (68.33%) males and 19 (31.66%) females participated in our study. The mean age of the patients was 27.97±7.36 years. The mean disease duration was 5±7.11 months. The mean baseline, 3-month and 6-month SALT scores of the patients receiving PRP treatment were 6.03±0.89, 2.53±2.01 and 0.93±1.72, respectively. A statistically significant decrease was found between the SALT scores at baseline, 3rd month and 6th month of the patients treated with PRP (p<0.001). The mean baseline, 3-month and 6-month SALT scores of the patients treated with intralesional triamcinolone acetonide were 6.07±0.78, 2.60±2.07 and 1.27±2.03, respectively. A statistically significant decrease was found between the SALT scores at baseline, 3rd month and 6th month in patients receiving intralesional triamcinolone acetonide treatment (p<0.001). No statistically significant difference was found between the 2 groups when SALT score changes were compared between baseline and 3rd month (p=0.951), between baseline and 6th month (p=0.576) and between 3rd month and 6th month (p=0.568). No significant difference was found between age, gender, disease duration and family history and treatment response. When the 3rd month treatment response of 30 patients who underwent PRP treatment was analysed, 4 (13.33%) patients had no response, 7 (23.33%) patients had partial response, 7 (23.33%) patients had good response and 12 (40%) patients had very good response. At the end of the 6th month, 2 (6.66%) patients had no response, 2 (6.66%) patients had partial response, 3 (10%) patients had good response and 23 (76.66%) patients had very good response. When the 3rd month treatment response of 30 patients receiving intralesional triamcinolone acetonide treatment was analysed, it was evaluated as non-response in 5 (16.66%) patients, partial response in 8 (26.66%) patients, good response in 7 (23.33%) patients and very good response in 10 (33.33%) patients. At the end of the 6th month, 3 (10%) patients had no response, 3 (10%) patients had partial response, 4 (13.33%) patients had good response and 20 (66.66%) patients had very good response. After PRP and intralesional triamcinolone acetonide procedure, no other side effects other than minor side effects such as mild pain, burning, ecchymosis and tenderness were reported. The general treatment and follow-up periods of the patients were determined as 6 months. At the end of the follow-up period, out of 55 patients who responded to the treatment, relapse developed in 3 patients after 6 months, 1 patient in the group receiving PRP treatment and 2 patients in the group receiving ILKS treatment. Conclusion: No difference was found between the 2 groups. However, although no statistically significant difference was found, it was observed that the decrease in SALT score tended to be faster or higher in the PRP group than in the intralesional triamcinolone acetonide group. Key words: Alopecia areata, Platelet Rich Plasma, Intralesional triamcinolone acetonide