Novel Insights from Clinical Practice

Rodríguez-Villa Lario A.a,b· Aguado-García Á.c· Andrés-Lencina J.J.c· Corredera C.c· García-Legaz Martínez M.c· Alonso de Celada R.M.a· Subiabre-Ferrer D.c· Valenzuela-Oñate C.c· Ricart-Vayá J.M.a,c· Gómez-Zubiaur A.a,b

Author affiliations

aTrichology Unit, Instituto Médico Ricart, Hospital Ruber Internacional, Grupo Quirónsalud, Madrid, Spain
bDepartment of Dermatology, Hospital Universitario Príncipe de Asturias, Madrid, Spain
cTrichology Unit, Instituto Médico Ricart, Hospital Quirónsalud Valencia, Valencia, Spain

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Article / Publication Details

First-Page Preview

Received: February 28, 2022
Accepted: April 20, 2022
Published online: May 24, 2022

Number of Print Pages: 6
Number of Figures: 2
Number of Tables: 1

ISSN: 2296-9195 (Print)
eISSN: 2296-9160 (Online)

For additional information: https://www.karger.com/SAD

Abstract

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.

© 2022 S. Karger AG, Basel

References Yoo KH, Kim MN, Kim BJ, Kim CW. Treatment of alopecia areata with fractional photothermolysis laser. Int J Dermatol. 2010;49(7):845–7. Bae JM, Jung HM, Goo B, Park YM. Hair regrowth through wound healing process after ablative fractional laser treatment in a murine model. Lasers Surg Med. 2015;47(5):433–40. Yalici-Armagan B, Elcin G. The effect of neodymium: yttrium aluminum garnet and fractional carbon dioxide lasers on alopecia areata: a prospective controlled clinical trial. Dermatol Surg. 2016;42(4):500–6. Perper M, Aldahan AS, Fayne RA, Emerson CP, Nouri K. Efficacy of fractional lasers in treating alopecia: a literature review. Lasers Med Sci. 2017 Nov;32(8):1919–25. El-Husseiny R, Elframawy S, Abdallah M. Comparative study between fractional carbon dioxide laser vs intralesional steroid injection in treatment of alopecia areata. Dermatol Ther. 2020 Jul;33(4):e13742. Haak CS, Hannibal J, Paasch U, Anderson RR, Haedersdal M. Laser-induced thermal coagulation enhances skin uptake of topically applied compounds. Lasers Surg Med. 2017 Aug;49(6):582–91. Taudorf EH, Lerche CM, Erlendsson AM, Philipsen PA, Hansen SH, Janfelt C, et al. Fractional laser-assisted drug delivery: laser channel depth influences biodistribution and skin deposition of methotrexate. Lasers Surg Med. 2016 Jul;48(5):519–29. Taudorf EH, Lerche CM, Vissing AC, Philipsen PA, Hannibal J, D’Alvise J, et al. Topically applied methotrexate is rapidly delivered into skin by fractional laser ablation. Expert Opin Drug Deliv. 2015 Jul;12(7):1059–69. Aickara D, Bashyam AM, Pichardo RO, Feldman SR. Topical methotrexate in dermatology: a review of the literature. J Dermatolog Treat. 2022;33(1):512–17. Elsaie ML, Hasan MS. Successful treatment of long-standing alopecia totalis with intralesional methotrexate. J Cosmet Dermatol. 2022 Feb;21(2):855–6. Hamdino M, El-Barbary RA, Darwish HM. Intralesional methotrexate versus triamcinolone acetonide for localized alopecia areata treatment: a randomized clinical trial. J Cosmet Dermatol. 2022 Feb;21(2):707–15. Ahmed G, Khare S, Ganguly S, Chhabra N, Prabha N. Topical methotrexate 1% gel for the treatment of localized alopecia areata. Int J Dermatol. 2020 Aug;59(8):e292–3. Article / Publication Details

First-Page Preview

Received: February 28, 2022
Accepted: April 20, 2022
Published online: May 24, 2022

Number of Print Pages: 6
Number of Figures: 2
Number of Tables: 1

ISSN: 2296-9195 (Print)
eISSN: 2296-9160 (Online)

For additional information: https://www.karger.com/SAD

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