Background
Alopecia areata (AA) places a considerable burden on patients. While intralesional glucocorticoid injection is an important therapy, it can cause severe pain.
Objective
To compare the efficacy and pain levels of microneedle transdermal delivery of compound betamethasone versus traditional intralesional injection in mild-to-moderate AA.
Methods
We conducted a randomized controlled trial in AA patients with a Severity of Alopecia Tool (SALT) score <50. Both groups received monthly compound betamethasone injections: group A via intralesional injections and group B via transdermal microneedle delivery. The primary outcome was the reduction in SALT score after 3 months.
Results
With 80 patients enrolled, baseline SALT scores were similar between group A (9.250 ± 5.300) and group B (10.65 ± 9.445). After 3 months, the mean SALT reduction was 7.000 ± 4.5017 in group A and 8.075 ± 8.014 in group B, with no statistical difference. Remission rates for SALT30/50/75/90 were 92.50/90.00/57.50/42.50% in group A and 95.00/87.50/72.50/40% in group B, with no significant difference. Group B had a significantly lower visual analog scale pain score than group A (4.000 ± 1.174 vs 5.281 ± 2.098, P = .0047).
Limitations
The study focused on mild-to-moderate patchy AA, limiting insights into severe cases.
Conclusion
Microneedle transdermal delivery of compound betamethasone in mild-to-moderate patchy AA demonstrates efficacy comparable to traditional intralesional injection with reduced pain.
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