Reply

The document discusses concerns regarding the use of interferon alfa (IFN-α) for treating hemangiomas in children, particularly the risk of neurotoxicity such as spastic diplegia. It references recent reports of such adverse effects, including one by Chang et al. that described delayed ambulation and spastic diplegia in an infant treated with IFN-α2b, and another by Barlow et al. that observed spastic diplegia in five children during IFN-α2a therapy, with some recovery upon discontinuation. The authors recommend clinical assessment of neurodevelopmental status before and during IFN therapy, evaluation of abnormal findings with MRI, and consideration of IFN discontinuation regardless of MRI findings. They also suggest that opioid receptor antagonists like naloxone and naltrexone may reverse neurotoxic effects of IFN-α, potentially allowing continued therapy. The document also briefly mentions chronic telogen effluvium (CTE) as a potential complication in clinical trials for female androgenetic alopecia (AGA), noting that CTE can be mistaken for AGA and may affect study results. It suggests that careful exclusion of subjects with CTE from trials and possibly using a 4 mm punch biopsy for horizontal sectioning may be necessary for accurate diagnosis and study outcomes.