Successful treatment of long-standing alopecia totalis with intralesional methotrexate

Dermoscopy-assisted prevalence of hair loss after COVID-19 vaccination among an Egyptian population: a cross-sectional study

ABSTACT

BACKGROUND: Coronavirus disease (COVID-19) currently named SARS-CoV-2 is a contagious disease caused by a coronavirus; incompatible data are present on the possible relationship among COVID-19 vaccines and hair loss.

AIMS

The objective of the current study was to assess dermoscopically the prevalence of hair loss among an Egyptian population following COVID-19 vaccination.

METHODS

A total of 2000 participants were enrolled in this cross-sectional study. Adult males and females who received one of recognized COVID-19 vaccine were included, irrespective of the status of previous COVID-19 infection. Those who were aged less than 18 years or above 60 years were excluded. Furthermore, subjects self-reporting hair loss were assessed by dermoscopy.

RESULTS

Among the studied cases, n = 478 (23.9%) complained of hair loss following vaccination. The majority of cases noticed their hair loss during the first 2 months post-vaccination (n = 215 after the first month and n = 158 after the 2nd month respectively).

CONCLUSION

We reported prevalence of post-vaccination hair fall that was confirmed by trichoscopy and which affected approximately one quarter of participants who received COVID-19 vaccines. Other factors, such as stress and infection, cannot be excluded and remain to be further investigated by larger multicenter studies.

Efficacy of Jessener solution versus intralesional steroid in treatment of alopecia areata

BACKGROUND

Alopecia areata is an autoimmune condition that causes non-scarring hair loss. To date, there is no single cure and treatment remains challenging.

OBJECTIVES

To evaluate the efficacy of Jessener solution versus intralesional steroid in treatment of Alopecia Areata.

METHODS

This study included 40 patients who presented with multifocal patchy alopecia areata (AA). For each patient, three patches were randomly selected to be treated one with intralesional steroid, another with topical Jessner solution and the third with normal saline. Three sessions were done 3 weeks apart and were followed up for 3 months. Response was assessed clinically and by trichoscope.

RESULTS

Fifteen percent of patches coated with Jessner or injected with steroids showed an excellent response while 20% of patches coated with Jessner and 32.5% patches injected with steroids showed a good response. A significant difference was observed between the three modalities of treatment regarding the prognostic score for response (p < 0.001) as patches coated with Jessner and those steroid injected showed a significant higher response rate than patches injected with saline (p < 0.001) while no significant difference was reported between patches either treated with Jessner or steroids (p > 0.05).

CONCLUSION

Jessners solution can be a novel and feasible and well tolerated modality of treatment for patients suffering from alopecia areata.

Successful Response to a Combination of Intralesional Methotrexate and Fractional CO2 Laser in Refractory Alopecia Areata: Case Report

Introduction

Refractory cases of alopecia areata (AA) may be considered a therapeutic challenge. Intralesional methotrexate (IL-MTX) has been used in other dermatological diseases rather than AA. Likewise, its topical use as an immunosuppressant drug may be of interest for the control of the lymphoid infiltrate in AA. On the other hand, the use of fractional ablative laser is supported in literature as an alternative or complementary treatment in AA, whilst the generation of columns of thermal damage may favour the migration of cells and cytokines that are beneficial.

Case Presentation

In this paper, we present 2 cases in which IL-MTX and ablative fractional CO2 laser were combined with excellent outcomes.

Conclusion

Previous research encompasses a total of 23 patients. Most patients presented with patchy AA. The doses administered ranged from 2.5 to 50 mg with an average frequency of 3 weeks. On average, most patients required a minimum of 3 sessions. One case employed 1% topical methotrexate ointment. Adverse local events were mild and transient. In conclusion, the concomitant application of these treatments has not been reported previously. Specific recommendations relating to the appropriate dosing of the drug, frequency of administration, and requirements for analytical control studies should be determined in further studies.