局部注射曲安奈德、甲氨蝶呤和维生素 D 治疗脱发:叙述性综述

Asmaa Al Refaei, Yossra Mostafa, Karem Ibrahim
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摘要

背景:斑秃(Alopecia areata,AA)是一种非瘢痕性自身免疫性疾病,女性患者占很大比例。最有效的治疗方法是鞘内注射皮质类固醇激素。叶酸拮抗剂甲氨蝶呤的免疫抑制作用对严重的 AA 非常有效。毛囊中含有大量的维生素 D 受体,角质形成细胞必须表达这些受体才能保持头发生长周期的正常。我们的目标是进一步了解直接向 AA 病灶注射曲安奈德(Triamcinolone Acetonide,TRA)、氨甲蝶呤(Methotrexate,MTX)和维生素 D3 的潜在益处。通过检索和分析 Medline 数据库(Pub Med 和 Medscape),研究了截至 2022 年用于治疗 AA 的曲安奈德、MTX 和维生素 D 的鞘内注射。纳入荟萃分析的论文是根据一套严格的标准筛选出来的。如果符合以下任何一项标准,我们就会考虑将其纳入:首先,必须用英语撰写。2.发表在有严格同行评审程序的期刊上。第三,分析向受累关节注射 TrA、MTX 和维生素 D 治疗 AA 的益处。提取数据:不符合纳入标准的研究未被纳入。一项研究的质量可通过检查其伦理批准、资格标准、控制、信息和评估方法来确定。我们的相关研究成果是通过使用每项合格研究的数据收集表独立摘录数据而获得的。我们的结论是,在治疗成年患者的局部 AA 时,鞘内注射 MTX 和维生素 D3 可能是鞘内注射 TrA 安全有效的替代疗法。由于毛发镜的作用,毛发再生和 AA 特异性毛发镜特征的丧失都可能在早期阶段被发现。
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Intralesional Injection of Triamcinolone Acetonide, Methotrexate and Vitamin D in Treatment of Alopecia Areata: A Narrative Review
Background: Alopecia Alopecia areata (AA) is a non-scarring autoimmune condition that affects a large percentage of women. The most effective therapy is the intralesional administration of corticosteroids. The immunosuppressive action of the folic acid antagonist methotrexate is quite effective in individuals with severe AA. Hair follicles have high levels of vitamin D receptors, and keratinocytes must express these receptors to keep the hair growth cycle regular. Our goal is to learn more about the potential benefits of injecting Triamcinolone Acetonide (TrA), Methotrexate (MTX), and vitamin D3 directly into AA lesions. Intralesional injections of TrA, MTX, and vitamin D for the treatment of AA up to 2022 were studied by searching and analysing Medline databases (Pub Med and Medscape). The papers that were included in the meta-analysis were chosen based on a strict set of criteria. If they met any of the following criteria, we considered them for inclusion: First, it must be written in English. 2. Appear in journals with a strict peer review process. Third, analyse the benefits of injecting TrA, MTX, and vitamin D into the affected joint to treat AA. Extraction of Data: Research Studies were not included if they did not meet the inclusion criteria. The quality of a study may be determined by checking its ethical approval, eligibility criteria, controls, information, and evaluation methods. Our concerned research results were captured by independently abstracting data utilising a data collecting form from each qualifying study. We conclude that intralesional MTX and vitamin D3 may be safe and effective therapeutic alternatives to intralesional TrA for the treatment of localised AA in adult patients. Hair regrowth and the loss of AA-specific trichoscopic characteristics might both be detected at earlier stages thanks to trichoscopy's usefulness.
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