Treatment of Severe Alopecia Areata with Intralesional Steroid Injections

The study reviewed the treatment of extensive alopecia areata (over 50% but under 99% scalp involvement) with intralesional triamcinolone acetonide injections. Out of 10 patients, 6 responded positively to the treatment, particularly those with exclamation mark hairs and a positive hair pull test. Complications were minimal, with only mild reversible atrophy in 3 patients. The treatment was well tolerated, and pain was reduced using a topical anesthetic. The study concluded that intralesional triamcinolone acetonide is a safe and effective treatment for extensive alopecia areata, especially in patients showing specific initial physical examination signs.