Dermatologica Sinica

ORIGINAL ARTICLE
Year
: 2022  |  Volume : 40  |  Issue : 2  |  Page : 85--93

The optimal concentration of intralesional triamcinolone acetonide for patchy alopecia areata: A systematic review and meta-analysis


Hsuan-An Su1, Yu-Tsung Chen2, Yu-Chia Chen1 
1 Department of Dermatology, Far Eastern Memorial Hospital, New Taipei City, Taiwan
2 Department of Dermatology, Taipei Medical University Shuang Ho Hospital; School of Public Health, College of Public Health and Nutrition, Taipei Medical University, Taipei, Taiwan

Correspondence Address:
Dr. Yu-Chia Chen
No. 21, Section 2, Nanya South Road, Banciao District, New Taipei City 220
Taiwan

Background: Intralesional steroid treatment for alopecia areata (AA) has been developed for decades, yet the optimal concentration of triamcinolone acetonide (TrA) is not well-established. Objectives: This review aims to determine the optimal concentration of intralesional TrA in treating patchy AA. Methods: We conducted a systematic review and meta-analysis, and searched the Cochrane Library, Embase, and PubMed databases on July 4, 2021, to identify randomized or nonrandomized comparative studies reporting the response rates and/or adverse events among AA patients treated with various concentrations of TrA. The meta-analysis of proportions and odds ratios was analyzed using random-effects modeling. Results: Nineteen studies and a total of 783 participants were included. The estimated response rate of 5 mg/dl (74.82%, 95% confidence interval [CI] 64.99%–83.50%) was shown to be more efficacious than 2.5/3.33 mg/dl (38.64%, 95% CI 16.98%–62.99%) but similar to 10 mg/dl (71.06%, 95% CI 59.72%–81.20%), while pooled estimate of odds ratios revealed higher efficacy with 10 mg/dl than 5 mg/dl (odds ratio = 1.64, 95% CI 1.05–2.58, P = 0.031). The rates of skin atrophy were 18.05% (95% CI, 10.32%–27.38%), 11.49% (95% CI, 2.86%–24.84%), and 3.85% (95% CI, 1.27%–14.01%) in groups 10, 5, and 2.5/3.33 mg/dl, respectively. Higher concentration is associated with more skin atrophy in a dose-dependent fashion (P = 0.012). Heterogeneity among studies in the meta-analyses was high. Conclusion: The optimal intralesional concentration of TrA for patchy AA is probably 10 mg/dl with acceptable adverse events.


How to cite this article:
Su HA, Chen YT, Chen YC. The optimal concentration of intralesional triamcinolone acetonide for patchy alopecia areata: A systematic review and meta-analysis.Dermatol Sin 2022;40:85-93


How to cite this URL:
Su HA, Chen YT, Chen YC. The optimal concentration of intralesional triamcinolone acetonide for patchy alopecia areata: A systematic review and meta-analysis. Dermatol Sin [serial online] 2022 [cited 2022 Oct 7 ];40:85-93
Available from: https://www.dermsinica.org/article.asp?issn=1027-8117;year=2022;volume=40;issue=2;spage=85;epage=93;aulast=Su;type=0