甲氨蝶呤局部注射治疗斑秃的疗效观察

S. Abdelsalam, Mervat Hamdino, Hanan Darwish
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引用次数: 0

摘要

背景斑秃(AA)的治疗仍然具有挑战性,因为有多种治疗选择,但没有完全治愈或预防的治疗方法。目的评价甲氨蝶呤(MTX)局部注射治疗局限性AA的临床及皮肤镜疗效和安全性。患者和方法本研究共纳入30例18-55岁的局限性AA患者。每例患者均采用局部注射MTX (25mg /ml)治疗,间隔2周,共4次,随访3个月。在治疗结束、治疗后1、2和3个月,用再生量表和皮肤镜对目标病变进行临床评估。结果研究结束时,病灶内MTX的有效率为93.3%,15例(50.0%)患者的评分为4分(再生≥75%)。在随访结束、4周、8周和12周之间,再生规模有统计学上的显著差异。在随访结束、4周、8周和12周时,皮肤镜参数也有统计学意义上的显著降低,再生规模和皮肤镜结果之间存在显著的临床皮肤镜关系。无复发(0.0%)。结论局灶内甲氨蝶呤治疗局限性AA安全有效,无明显不良反应。皮肤镜检查可用于评估AA病变对治疗的反应。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Efficacy of intralesional methotrexate in the treatment of alopecia areata
Background Alopecia areata (AA) treatment is still challenging as multiple treatment options are available, but there is no fully curative or preventive treatment. Aim To evaluate the efficacy and safety of intralesional methotrexate (MTX) in the treatment of localized AA both clinically and dermoscopically. Patients and methods A total of 30 patients aged 18–55 years with localized AA were enrolled in this study. Each patient was treated by intralesional MTX (25 mg/ml) at 2-week intervals for four sessions and followed up for 3 months. The target lesions were evaluated clinically using regrowth scale and dermoscopically at the end of sessions, 1, 2, and 3 months after treatment. Results At the end of study, the response rate to intralesional MTX was ∼93.3%, and 15 (50.0%) patients showed a score of 4 (regrowth ≥75%). There was a statistically significant difference in regrowth scale between end of sessions, 4, 8, and 12 weeks of follow-up. There was also statistically significant reduction in dermoscopic parameters at the end of sessions, 4, 8, and 12 weeks of follow-up with a significant clinicodermoscopic relation between regrowth scale and dermoscopic findings. No patient (0.0%) showed recurrence. Conclusion Intralesional MTX can be an effective and safe therapeutic option for localized AA with no significant adverse effects. Dermoscopy can be used for evaluating the response of AA lesion to treatment.
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