Evaluation of The Effects and Side Effects of Topical Clobetasol 0.05% and Topical Anthralin Treatment in Alopecia Areata with Phototricogram

Objective: Alopecia areata (AA) is a chronic inflammatory disease characterized by non-scarring hair loss. In this study, we aimed to investigate the effects and side effects of topical anthralin and topical clobetasol propionate treatment in patients with AA using a phototrichogram. Material and methods: The study included 40 patients with AA who were randomly divided into two groups: topical anthralin (n=20) and clobetasol 17-propionate 0.05% (n=20). Phototrichogram values were assessed before and after treatment. Results: An evaluation of treatment response at the end of three months indicated inadequate response in 7 (35%), partial response in 8 (40%), and cosmetic response in 5 (25%) of the patients in the clobetasol 17-propionate 0.05% group as opposed to inadequate response in 4 (20%), partial response in 8 (40%), and cosmetic response in 8 (40%) of the patients in the local anthralin group. Although the cosmetic response rate was higher in the local anthralin group, there was no significant difference (p=0.470). The rate of patients unresponsive to treatment was lower in the topical anthralin group, while no significant difference was established (p<0.05). In patients whose treatment was not changed throughout the 6 months, cosmetic response was observed in 6 (46.1%) out of 13 (65%) patients who received local clobetasol 17-propionate 0.05% and in 10 (62.5%) out of 16 (80%) patients who received local anthralin and no significant difference was found between the groups (p=0.379). Statistically, treatment success was significantly higher in patients who did not respond to local clobetasol 17-propionate 0.05% treatment and were converted to anthralin treatment than those who underwent a treatment change (p=0.026). On the other hand, at the end of the 6 months, it was revealed that both drugs had no significant effect on the increase in the number of hair follicles per mm2 (NH), hair density (HD), anagen rate (AR), and telogen rate (TR) values (p=0.148). Conclusion: Topical clobetasol 17 propionate 0.05% lotion and topical anthralin treatment is a safe and effective form of patchy AA treatment. When both drugs were compared, treatment success was statistically superior when switched to topical anthralin treatment in patients who did not respond to topical clobetasol 17 propionate 0.05% lotion. The results of our study and literature reviews indicate the necessity of studies with larger patient series in terms of the effectiveness of these two drugs.