Cryotherapy with intralesional steroids versus intralesional pentoxifylline in the treatment of Recalcitrant Alopecia areata- a Randomized Control Trial

Abstract

BACKGROUND: In clinical practice, recalcitrant alopecia areata is common, and most conventional therapies have either failed to treat the condition or caused recurrence in certain patients. Recalcitrant alopecia areata is characterized by a disease duration of more than six months and no response to more than three different forms of treatment.
Few studies have evaluated the effectiveness of cryotherapy and intralesional pentoxifylline as a monotherapy in treating alopecia areata. The purpose of this study was to compare cryotherapy with intralesional steroids with that of intralesional pentoxifylline.
METHODOLOGY: A Randomized Control Trial (RCT) was conducted on 50 patients with Recalcitrant scalp alopecia areata. They were divided into 2 groups (Group A & Group B).25 patients in (Group A) received cryotherapy with intralesional triamcinolone acetonide 5mg/ml over the alopecic patch. 25 patients in Group B received 1ml(20mg) of intralesional pentoxifylline(100mg/5ml) over the alopecic patch. Their efficacy and adverse effects were documented and compared once in 2 weeks for a total of 5 sittings.
RESULTS: According to the GPA scale and LAD score, the effectiveness of the treatment approach indicates significant improvement in both the groups initially but drastic improvement and patient satisfaction was observed in Group A with subsequent sittings.
CONCLUSION: This study showed that intralesional pentoxifylline is less efficacious when compared to cryotherapy with intralesional steroids. However, Intralesional pentoxifylline has lesser adverse effects when compared to cryotherapy with intralesional steroids.