A Retrospective Comparative Study of Two Concentrations of Intralesional Triamcinolone Acetonide in the Treatment of Patchy Alopecia Areata on the Scalp

Figures & data

Table 1 Demographic and Clinical Features of Patients in Treatment Groups

	Group 1 ILT: 5 mg/mL (N=46)		Group 2 ILT: 10 mg/mL (N=39)		P-value
	n	%	n	%
Gender
Female	21	45.7	17	56.4	0.323
Male	25	54.3	22	43.6
Age
Mean (SD) (years)	20.9 (11)		27.8 (14)
≤18	17	37.0	11	28.2	0.333
19–30	21	45.7	16	41.0
>30	8	17.4	12	30.8
Duration of treated AA patches
Mean (SD) (months)	13.6 (27)		10.5 (17)		0.933
≤2	16	34.8	15	38.5
3–6	13	28.3	10	25.6
>6	17	37.0	14	35.9
Number of patches
Mean (SD)	3.4 (4.2)		3.1 (3.7)		0.652
1	16	34.8	17	43.6
2	14	30.4	9	23.1
≥3	16	34.8	13	33.3
Scalp surface area affected %
Mean (SD)	5.4 (5.2)		5.3 (5.4)		0.858
<3	14	30.4	14	35.9
3–5	16	34.8	12	30.8
6+	16	34.8	13	33.3
Past history of AA	11	23.9	11	28.2	0.653
Personal history of atopy (atopic dermatitis, asthma, allergic rhinitis)	13	28.3	9	23.1	0.587
Comorbidities (hypothyroidism, low ferritin, hypertension, diabetes mellitus, juvenile rheumatoid arthritis, vitiligo, psoriasis, depression, anxiety)	13	28.3	9	23.1	0.587
Nail involvement (fine pitting, trachyonychia, leuconychia)	4	8.7	2	5.1	0.522
Extra scalp sites (eyebrow, moustache, legs, beard)	10	21.7	7	17.9	0.663
Family history of AA	6	13	7	17.9	0.536

Figure 1 Clinical pictures of patients with various hair regrowth scale (RGS), (A) RGS 0 (<10%), (B) RGS 1 (11–25%), (C) RGS 2 (26–50%), (D) RGS 3 (51–75%), (E) RGS 4 (>75%).

Figure 2 A patient with occipital and temporal patches showing complete hair regrowth after single injection of ILT10 mg/mL.

Figure 3 Skin atrophy observed at sites of ILT injection (arrows).

Table 2 Inter-Group Comparison of Response to Treatment

	Group 1: ILT 5 mg/mL (N=46)		Group 2: ILT 10 mg/mL (N=39)		P-value
	n/N	%	n/N	%
Patients with complete hair regrowth or hair RGS of 4 at 12 weeks	20/46	43.5	21/39	53.8	0.340
Patients with satisfactory outcome at 12 weeks (hair RGS 4 or 3)	29/46	63	30/39	76.9	0.166
Overall side-effects	8/46	17.4	10/39	25.6	0.354
Atrophy	5/46	10.8	6/39	15.3
Atrophy and telangiectasia	2/46	4.3	3/39	7.6
Folliculitis	1/46	2.1	0/39	0
Hypopigmentation	0/46	0	1/39	2.5
Recurrence after 1–3 years of follow-up	21/46	45.7	18/39	46.2	0.963

Table 3 Results of Multivariate Analysis

	Rate of Complete Hair Regrowth				Percentage of Patients with Satisfactory Outcome				Recurrence of AA After 1–3 Years of Follow-Up
	OR	95% CI		P-value	OR	CI 95%		P-value	OR	CI 95%		P-value
ILT conc. (10 mg/mL vs 5 mg/mL)	1.6	0.6	4.9	0.307	2.0	0.7	5.8	0.221	1.0	0.4	2.6	0.946
Gender (Male vs Female)	0.8	0.2	2.7	0.756	0.7	0.2	2.4	0.538	0.7	0.2	2.5	0.617
Personal history of AA (Yes vs No)	3.1	0.8	11.7	0.090	1.3	0.4	4.8	0.663	0.5	0.2	1.8	0.331
Atopy (Yes vs No)	1.2	0.3	4.1	0.790	0.5	0.1	1.8	0.297	1.3	0.4	4.4	0.713
Comorbidities (Yes vs No)	0.7	0.2	2.5	0.579	1.2	0.3	4.2	0.787	1.0	0.3	3.5	0.978
Nail involvement (Yes vs No)	2.2	0.2	23.0	0.517	1.1	0.1	11.5	0.907	2.2	0.2	23.0	0.796
Extra scalp sites (Yes vs No)	2.1	0.5	9.4	0.351	1.4	0.3	5.9	0.663	2.8	0.7	12.3	0.163
Age (years)	–	–	–	0.699	–	–	–	0.724	–	–	–	0.043
≤18	–	–	–	–	–	–	–	–	–	–	–	–
19–30	1.6	0.5	5.5	0.422	1.0	0.3	3.5	0.989	0.5	0.2	1.7	0.294
>30	1.4	0.3	6.0	0.664	0.6	0.1	2.6	0.464	3.0	0.7	12.3	0.126
Duration (months)	–	–	–	0.093	–	–	–	0.135	–	–	–	0.358
≤2	–	–	–	–	–	–	–	–	–	–	–	–
3–6	0.4	0.1	1.8	0.260	0.4	0.1	1.7	0.224	0.7	0.2	2.8	0.638
>6	0.2	0.0	0.9	0.029	0.2	0.1	1.0	0.045	1.9	0.5	6.9	0.333
Number of patches	–	–	–	0.833	–	–		0.977	–	–	–
1	–	–	–	–	–	–	–	–	–	–	–	–
2	1.1	0.2	6.1	0.905	1.2	0.2	7.4	0.867	1.7	0.3	8.8	0.556
≥3	0.7	0.1	4.4	0.718	1.2	0.2	8.7	0.828	1.6	0.3	10.7	0.608
Surface area affected%	–	–	–	0.371	–	–	–	0.371	–	–	–	0.685
<3	–	–	–	–	–	–	–	–	–	–	–	–
3–5	3.2	0.7	14.8	0.140	0.5	0.1	2.5	0.363	1.6	0.3	6.9	0.564
≥6	0.6	0.1	3.7	0.577	0.2	0.0	1.8	0.162	0.9	0.1	6.1	0.935
Family history of AA (yes vs No)	0.7	0.1	3.5	0.664	0.2	0.3	4.2	0.528	1.7	0.3	3.8	0.983

Abbreviations: OR, odds ratio; CI, confidence interval.