RESUMO
OBJECTIVE: To conduct a systematic review and meta-analysis to verify the efficacy of using autologous platelet-rich plasma (PRP) in female pattern alopecia (FPA). BACKGROUND: Androgenetic alopecia is the leading cause of hair loss in men andwomen and often impacts self-esteem and quality of life. DATA SOURCES: MEDLINE/PubMed, Cochrane Library, ClinicalTrials.gov, and EMBASE up to May 2021. STUDY SELECTION AND DATA EXTRACTION: We identified all studies evaluating the effect of PRP in FPA. A narrative synthesis was performed from data on the efficacy of PRP treatment and adverse effects; quantitative results of PRP use compared to control treatment for female androgenetic alopecia (AGA) were synthesized. The outcomes analyzed were terminal density and hair thickness. RESULTS: Seven articles were selected for this review. Meta-analysis showed that PRP-based interventions were able to increase terminal hair density compared to control (standardized mean difference (SMD)=2.98, 95% confidence intervals (CIs)=1.10, 4.85), with no significant increase in hair thickness (SMD = 1.16, 95% CI= -0.96, 3.28). During and after treatment, no major side effects were reported by patients or researchers. CONCLUSIONS: The use of autologous PRP injections in female AGA seems to be promising, with more consistent results on terminal hair density. However, caution is recommended in the interpretation of these results until they can be replicated in larger and more representative samples. PROSPERO registration number CRD42021257154.
Assuntos
Plasma Rico em Plaquetas , Qualidade de Vida , Masculino , Humanos , Feminino , Resultado do Tratamento , Alopecia/terapia , CabeloRESUMO
BACKGROUND: Betamethasone can be used for intralesional infiltration, but there is little evidence in the literature to indicate its effectiveness in alopecia areata. OBJECTIVE: To assess the safety and effectiveness of the use of different doses of intralesional betamethasone, when compared to triamcinolone acetonide for the treatment of alopecia areata. METHODS: We recruited 12 patients with alopecia patch divided into four quadrants. Each quadrant, after randomization, received an intralesional injection with one of the following treatments: triamcinolone acetonide 2.5 mg/ml, betamethasone 0.375 mg/ml, betamethasone 1.75 mg/ml, or 0.9% saline (placebo). The intervention was repeated in the same quadrant every 4 weeks, totaling 3 sessions. Visual and dermoscopic evaluation of the results were performed. Trial registration: ReBec RBR-5kyg2r. RESULTS: At 4 and 8 weeks of intervention, triamcinolone acetonide 2.5 mg/ml provided the best visual results. Nevertheless, at the end of the study, the best visual results were seen with both triamcinolone acetonide and betamethasone 1.75 mg/ml, with significant difference when compared to betamethasone 0.375 mg/ml and placebo (p=.0489 and <.0001, respectively). There was a progressive reduction in the number of dystrophic hairs in all quadrants. CONCLUSION: Triamcinolone acetonide shows earlier results in repilation, but at 12 weeks betamethasone 1.75 mg/ml had similar results.
Assuntos
Alopecia em Áreas , Triancinolona Acetonida , Alopecia em Áreas/tratamento farmacológico , Betametasona/uso terapêutico , Humanos , Injeções Intralesionais , Resultado do Tratamento , Triancinolona Acetonida/uso terapêuticoRESUMO
Left ventricular noncompaction is a rare congenital anomaly characterized by excessiveleft ventricular trabeculation, deep intertrabecular recesses and a thin compacted layerdue to the arrest of compaction of myocardial fibers during embryonic development. We reportthe case of a young patient with isolated left ventricular noncompaction, leading to refractoryheart failure that required extracorporeal membrane oxygenation followed by emergency hearttransplantation.