Therapeutic Effect of Superficial Cryotherapy versus Intralesional Corticosteroids injection in Alopecia Areata

Abstract

Our study aimed to evaluate and compare the efficacy and safety of superficial cryotherapy and ILCS in the treatment of patchy AA as well as reporting the side effects and to assess the relationship between the age of onset and duration of the disease with the treatment results obtained. This study was done on 21 patients with patchy AA. All were subjected to detailed history taking and examination to exclude patients with any infectious, inflammatory or autoimmune cutaneous or systemic disease. Each patient was subjected to receive superficial cryotherapy on one patch of AA, every 2 weeks for 3 months duration by spraying liquid nitrogen 3∼4 times on each AA patch for 2∼3 seconds per application, in addition to ILCS injections for another patch of AA, once monthly for 3 months (triamcinolone acetonide 1:7/1ml). Evaluation of treatment response was done through comparing patients' global photographs, and dermoscopic assessment before and after treatment using phototrichogram analysis for the photos. The obtained data were tabulated and statistically analyzed. Our results showed clinically significant improvement by comparing patients' photographs in most of the treated patients with superficial cryotherapy. In addition, folliscopy revealed increased terminal hair density but without statistical significance in both treatment groups. Vellus hair density, T/V hair ratio, BDs, YDs, and EMHs were also improved in both treatment groups. However, there was only statistically significant change of the mentioned dermoscopic findings in the superficial cryotherapy treatment group. This suggests that the superficial cryotherapy could yield better results in the treatment of patchy AA than the traditional ILCS. In conclusion, ILCS is an effective and well-known treatment modality for patchy AA. Superficial cryotherapy could yield better results in the treatment of patchy AA than the ILCS. Yet, further studies discussing different cryotherapy treatment protocols and involving a larger number of cases are needed to minimize statistical errors and to detect the most accurate treatment method with the greatest response results.