Research Article of American Journal of Dermatological Research and Reviews
Combining 308-monochromatic excimer phototherapy with monthly IM triamcinolone acetonide for the treatment of resistant alopecia totalis
Nabeel K. Alhamzawi
Department of Dermatology, Diwaniyah Teaching Hospital, Diwaniyah, Iraq
Background: Treatment of resistant alopecia totalis AT is a major problem in general practice. Some studies reported the use of either excimer-308 or intra-muscular triamcinolone acetonide as a monotherapy, with conflicting results.
Objective: To evaluate the therapeutic effect of combining 308-excimer phototherapy and intramuscular triamcinolone acetonide for the treatment of alopecia totalis.
Methods and Material: Ten patients with alopecia totalis were evaluated in this prospective interventional study. All patients were assigned to receive the thera-peutic regimen that includes monthly IM triamcinolone acetonide (TAC) for a maximum of six pulses and twice-weekly excimer phototherapy for 24 sessions.
Results: The overall response rate for this regimen was 90%, with four patients 40% achieving complete regrowth of hair (100%). Three patients have exhibited a satisfactory response (>70% regrowth). Unsatisfactory response ( >10-< 70% regrowth) was reported in two patients . Younger patients responded better, as did those with a shorter history of the disease P < 0.05. At follow-up, which continued for 8–12 months, recurrence was noted in two (22.2%) of the nine responders.
Conclusions: Combining excimer phototherapy with triamcinolone acetonide showed a promising effect on resistant AT. This treatment modality was effective and well tolerated particularly in young patients.
Keywords: Alopecia totalis, excimer light, Triamcinolone acetonide, Combined treatment
How to cite this article:
Nabeel K. Alhamzawi. Combining 308-monochromatic excimer phototherapy with monthly IM triamcinolone acetonide for the treatment of resistant alopecia totalis. American Journal of Dermatological Research and Reviews, 2021, 4:37. DOI: 10.28933/ajodrr-2020-11-2605
1. Lee HH, Gwillim E, Patel KR, Hua T, et al. Epidemiology of Alopecia Areata, Ophiasis, Totalis, and Universalis: A systematic review and meta-analysis. Journal of the American Academy of Dermatology. 2020 Volume 82, Issue 3, 675 – 682
2. Burroway B, Griggs J, Tosti A. Alopecia Totalis and Universalis long-term outcomes: a review. J Eur Acad Dermatol Venereol. 2019 Oct 8. doi: 10.1111/jdv.
3. Simakou T, Butcher JP, Reid S, Henriquez FL. Alopecia areata: A multifactorial autoimmune condition. J Autoimmun. 2019 Mar 98:74-85.
4. Kassira S, Korta DZ, Chapman LW, Dann F. Review of treatment for alopecia totalis and alopecia universalis. Int J Dermatol 2017 Aug; 56(8): 801-810.
5. Burton, J. and Shuster, S. Large doses of glucocorticoid in the treatment of alopecia areata. Acta Derm Venereol. 1974; 55: 493–496.
6. Seiter S, Ugurel S, Tilgen W, Reinhold U. High-dose pulse corticosteroid therapy in the treatment of severe alopecia areata. Dermatology. 2001; 202(3):230-4.
7. Tsai YM, Chen W, Hsu ML, Lin TK. High-dose steroid pulse therapy for the treatment of severe alopecia areata. J Formos Med Assos. 2002; 101(3):223-6.
8. Vijayakumar M, Thappa DM. Dexamethasone pulse therapy for extensive alopecia areata. To use or not to use. Indian J Dermatol Venereol Leprol 2002; 68: 52-3.
9. Seo J, Lee Yl, Hwang S, Zheng Z, Kim DY. Intramuscular triamcinolone acetonide: An undervalued option for refractory alopecia areata. J Dermatol. 2017; 44(2): 173-179.
10. Kurosawa M, Nakagawa S, Mizuashi M, Sasaki Y, Kawamura M, Saito M, Aiba S. A comparison of the efficacy, relapse rate and side effects among three modalities of systemic corticosteroids therapy for alopecia areata. Dermatology 2006; 212(4): 361-5.
11. Ohtsuki A, Hasegawa T, Komiyama E, Takagi A, Kawasaki J, Ikeda S. 308-nm Excimer Lamp for the Treatment of Alopecia Areata: Clinical Trial on 16 Cases. Indian J Dermatol. 2013 Jul;58(4):326.
12. Al Hamzawi NK. Evaluation of the Efficacy and Safety of 308-nm Monochromatic Excimer Lamp in the Treatment of Resistant Alopecia Areata. Int J Trichology. 2019 Sep-Oct;11(5):199-206.
13. Arakawa Y, Nomiyama T, Katoh N. Three hundred and eight-nanometer excimer light therapy for alopecia universalis that is resistant to other treatment: A clinical study of 11 patients. J Dermatol 2016; 43(12): 1412-1416.
This work and its PDF file(s) are licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.