Comparative study of the effectiveness of fractional CO2 laser with topical triamcinolone acetonide versus intralesional triamcinolone acetonide injection in the treatment of patients with alopecia areata

Comparative study of the effectiveness of fractional CO2 laser with topical triamcinolone acetonide versus intralesional triamcinolone acetonide injection in the treatment of patients with alopecia areata referred to Razi Hospital

A randomized, single-blind, parallel-group, controlled clinical trial was conducted based on randomized blocks on 35 patients with alopecia areata.

Razi Hospital, Allopath Patch Patients are randomly divided into two groups A and B: Group A: Treated with CO2 laser plus topical triamcinolone acetonide cream Group B: Treated with intradermal triamcinolone acetonide injection Both groups received 4 sessions of treatment at 4-week intervals. Treatment efficacy was assessed by SALT score, dermoscopy, and VAS/VDS scales. Alopecia areata predictive score was measured according to dermoscopic criteria. Adverse events collected from both treatments were assessed by a dermatologist who was blinded to the treatment method performed on each patch (evaluator).Also, side effects and patient satisfaction are recorded.

Patients with alopecia areata(AA) over 15 years of age who have at least 2 or more comparable, anatomically similar, symmetrical alopecia patches on both sides of the head, at least 2 cm apart, and SALT less than 25%, and who have not received systemic medication or intralesional injection effective for alopecia areata in the last 2 months, will be included in the study.Also, patients with systemic diseases, immunocompromised patients, and pregnant patients were excluded from the study.

Treatment (A, i.e. laser + topical triamcinolone) and treatment (B, i.e. local injection of triamcinolone with a needle) are used randomly in the right or left allopic patch for each patient.

Increase Severity of Alopecia Tool score

The study method is a clinical trial, patients receive the desired treatment using the randomization method in the form of a random list, which is explained below. For this purpose, we assign an English letter to each of the treatment methods, which in this study, since two types of treatment are examined, treatment (A, i.e. co2 laser) and treatment (B, i.e. local injection of triamcinolone with a needle) are used.Treatment (A, i.e. microneedle) and treatment (B, i.e. local injection of triamcinolone with a needle) are used. On the other hand, since each patient receives both treatments and statistical methods have more power with equal volume in each treatment group, in order to obtain equal sample size for each treatment method, we proceed as follows: we define two drug combinations AB and BA.The AB combination means that treatment A will be injected for the person's right side and treatment B for the person's left side. Similarly, the BA combination means that treatment B will be injected for the person's right side and treatment A for the person's left side.Next, to prepare the random list, a random number table is used in such a way that a random number from 0 to 9 is generated for each patient. If the generated number is between 0 and 4, the AB combination is considered, and if the selected number is between 5 and 9, the BA combination is considered. To prepare the random list, the Random Allocation Software will be used, the output of which is reported below.

The randomized, parallel-group clinical trial was designed as a single-blind study. Thus, each alopecia patch was assigned to only one of the two intervention or control groups. In order to maintain blinding, the interventions in the two groups were made similar in terms of appearance, method of administration, and visit schedule.Randomization codes were generated by an independent researcher and stored in sealed envelopes. The outcome assessor was also unaware of the allocation of patients to treatment groups, and the grouping codes were only revealed after data collection was completed and the database was locked. This blinding method minimized the possibility of bias in the assessment of intervention effectiveness.

after making the data unidentifiable, it would be publishable.

3 months after publishing the article

It will be available to researchers working in academic and scientific institutions.

those who send emails to the corresponding author.

To receive the documentation of this research, please submit your request to the email address of Dr. Narges Ghandi (corresponding author) at Nghandi@tums.ac.ir.

Send an email to the author responsible for the study, documents, and data within two weeks to a maximum of one month from the date of submitting the request. The data will be sent in Excel format and, if requested, clinical photographs of the patients.