Comparative Study between Intralesional Pentoxifylline and Steroid in Localized Alopecia Areata

Background: Alopecia Areata (AA) is a classic autoimmune disorder, with a fluctuating course and no definitive treatment with guaranteed outcome. Intralesional corticosteroids are the most commonly prescribed treatment for patchy AA, but with a typical outcome of localized regressionAim of the Work: To evaluate the efficacy and safety of intralesional injection of pentoxifylline in localized alopecia areata compared to intralesional injection of triamcinolone acetonide (TrA).Patients and Methods: Thirty patients with localized alopecia areata, involving at least two patches, were included in this study. In each patient, one patch was treated with intralesional pentoxifylline (PTX) and another patch with intralesional corticosteroids (ILCs). Assessments were conducted every four weeks for a total of 15 weeks. Evaluation was completed at baseline, post-treatment, clinically using the SALT score, dermoscopically, and photographically.Results: Both treatment protocols resulted in significant improvement of SALT score and dermoscopic findings post-treatment. Comparison of the two treatment modalities revealed a 100% hair regrowth rate after intralesional corticosteroids (ILC) and a 60% improvement after intralesional pentoxifylline (PTX), with a statistically significant difference. Adverse effects included temporary pain during injection. Both treatment strategies demonstrated efficacy in the management of patchy alopecia areata, with the highest effectiveness observed following the ILCs procedure due to greater and earlier hair regrowth.Conclusion: Pentoxifylline is a potent and safe therapeutic approach for alopecia areata and can be used as an alternative to intralesional corticosteroid injection.