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Intralesional corticosteroids-

  • Inject plaques at 1cm-2cm intervals with insulin syringe.
  • Triamcinolone acetonide 5mg/ml- 0.05ml to be injected in each site. Sometimes 10mg/ml is required
  • Reinject at 4-6wks interval.
  • If no growth is present at 3 months then discontinue.
  • Thinning of regrown hair at 3-6mths, can be injected if necessary.

Pulse Therapy-

Systemic Corticosteroid 1mg of Betamethasone / Dexamethasone for 2 consecutive days. Repeat every week for 4wks.


Topical Immunotherapy-

To be considered if more than 50% scalp is involved.

  1. Topical application such as DNCB- Dinitrochlorobenzene, SADBE-    
    Squaric acid Dibutylester. Changes T4:T8 ratio from 4:1 to 1:1AT Allergic contact sensitization

S/E- Mutagen

  1. Topical Anthralin- 0.025% once or twice a week for 6-8wks, can be increased upto 1%. Combination of 0.5% Anthralin with Minoxidil 5% increases the response rate.
  2. Minoxidil- Potent peripheral vasodilator (2%,5%)- Immunomodulation (10%)-Stimulation of follicular epithelium S/E- Hypertrichosis
  3. Topical Corticosteroids under occlusion
  4. Topical Tacrolimus 0.1%
  5. PUVA therapy

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