Intralesional Platelet-Rich Plasma Injection in Patients with Recalcitrant Alopecia Areata

Objectives: Alopecia areata (AA) is a common, chronic autoimmune disease that causes non-cicatricial hair loss. Its relapsing and remitting nature leads to the search for new, effective treatment options. The study aimed to evaluate the therapeutic efficacy of intralesional platelet-rich plasma (PRP) and intralesional steroid (ILS) injections in patients with AA.
Methods: A retrospective chart review was carried out from 2020-2021. A total of 75 patients with AA were included in the study. Thirty-six patients were treated with intralesional PRP, and 39 patients were treated with ILS injections for three sessions. The patients were evaluated with a hair pull test and SALT scores at months 0, 3, and 6.
Results: Of 75 patients, the mean age of the PRP group was 34.33±10.61, and the mean age of the ILS group was 33.82±13.31 years. After three PRP or ILS therapy sessions, at 3. and 6. months, SALT 3 and SALT 6 scores were statistically significantly lower in the PRP group than in the ILS group (p=0.038, p<0.001, respectively). When the treatment response was evaluated at the end of the 6th month in the PRP group, there was no response in 2 (5.5%) patients, partial response in 1 (2.7%) patient, good response in 3 (8.4%) patients, and very good response in 30 (83.4%) patients. Only 2 (5.9%) patients had a clinical relapse in a 6-month period. Side effects were seen in 16 (44.4%) patients in the PRP group and 8 (20.5%) patients in the ILS group, and the frequency of side effects in the PRP group was statistically significantly higher than in the ILS group (p=0.026). However, the side effects of both groups were minor, such as itching, pain, burning, ecchymosis, and folliculitis.
Conclusion: PRP seems to be an effective and safe treatment option for limited patchy alopecia areata, but its superiority over ILS has not been fully demonstrated, making ILS still the first-line treatment.

Dirençli Alopesi Areata Hastalarýnda Ýntralezyonel Plateletten Zengin Plazma Enjeksiyonu

Amaç: Alopesi areata (AA), skatrisyel olmayan saç dökülmesine neden olan yaygýn, kronik otoimmün bir hastalýktýr. Tekrarlayan ve düzelen seyri, yeni ve etkili tedavi seçeneklerinin araþtýrýlmasýna yol açmaktadýr. Çalýþmanýn amacý, AA hastalarýnda intralezyonel plateletten zengin plazma (PRP) ve intralezyonel steroid (ILS) enjeksiyonlarýnýn terapötik etkinliðini deðerlendirmektir.
Metod: 2020-2021 yýllarý arasýnda retrospektif bir dosya incelemesi yapýldý. Çalýþmaya AA'lý toplam 75 hasta dahil edildi. Otuz altý hasta üç seans intralezyonel PRP ile ve 39 hasta üç seans ILS enjeksiyonu ile tedavi edildi. Hastalar 0, 3 ve 6. aylarda saç çekme testi ve SALT skorlarý ile deðerlendirildi.
Bulgular: Yetmiþ beþ hastadan PRP grubunun ortalama yaþý 34,33±10,61, ILS grubunun ortalama yaþý ise 33,82±13,31 yýldý. Üç PRP veya ILS tedavisi seansý sonrasý 3. ve 6. ayda SALT 3 ve SALT 6 skorlarý PRP grubunda ILS grubuna göre istatistiksel olarak anlamlý derecede düþüktü (p=0,038, p<0,001). PRP grubunda 6. ayýn sonunda tedavi yanýtý deðerlendirildiðinde 2 (%5,5) hastada yanýt yok, 1 (%2,7) hastada kýsmi yanýt, 3 (%8,4) hastada iyi yanýt ve 30 (%83,4) hastada çok iyi yanýt vardý. 6 aylýk dönemde sadece 2 (%5,9) hastada klinik relaps yaþandý. Yan etkiler PRP grubunda 16 (%44,4) hastada, ILS grubunda ise 8 (%20,5) hastada görüldü ve PRP grubunda yan etki sýklýðý ILS grubuna göre istatistiksel olarak anlamlý derecede yüksekti (p=0,026). Ancak her iki grupta da kaþýntý, aðrý, yanma, ekimoz ve folikülit gibi minör yan etkiler görüldü.
Sonuç: PRP, sýnýrlý yamalý AA için etkili ve güvenli bir tedavi seçeneði gibi görünmektedir, ancak ILS'ye üstünlüðü tam olarak gösterilememiþtir, bu da ILS'yi hala birinci basamak tedavi haline getirmektedir. (SETB-2025-03-065)