Karaninder Singh Mehta

Abstract

Introduction: Androgenetic alopecia (AGA) is one of the most common causes of hair loss among men and has very limited treatment options. Platelet?rich plasma (PRP) seems to be a new technique which may improve hair regrowth and has shown promising results. Aims and Objectives : This study was aimed at comparing the efficacy and safety of intradermal platelet rich plasma (PRP) therapy and topical minoxidil (5%) fortified with finasteride (0.1%) in the treatment of androgenetic alopecia. Materials and Methods : This was a prospective interventional study. In the study, patients were randomized into two groups – Group A (given PRP therapy) and Group B (given minoxidil fortified with finasteride therapy). Both groups were followed up over a period of 12 months, and final analysis was done with the help of global photography, standardized hair growth questionnaire, patient satisfaction score. A total of 60 patients clinically diagnosed with AGA were enrolled in the study with 30 patients in each group. Results: At the end of 12 months, 60 patients were evaluated to compare the efficacy of intradermal PRP and topical minoxidil therapy. It was observed that at end of 12 month, 22 (73.3%) patients in group A showed 1-25% improvement in hair growth and 8 (26.7%) patients showed 26-50% improvement while in group B 21 (70%) had 1-25% improvement in hair growth and 8 (26.7%) had 26-50% improvement.   Keywords: Androgenic alopecia, Platelet rich plasma minoxidil

Article Details

Abstract

Background: Viral warts are common dermatological diseases with wide range of treatment modalities. Utilization of various vaccines and skin test antigens has broadened the horizon of available immunotherapeutic agents for the treatment of warts. In this study, we compared efficacy and safety of intradermal and intralesional purified protein derivative (PPD) for treating common warts in children. Toevaluate efficacy and safety of intradermal and intralesional PPD in treatment of common warts in children. Materials and Methods: 180 children (aged 5-15 years) with common warts were randomly divided to receive intradermal (n=90) PPD 10 TU/0.1 ml at middle third of right forearm or intralesional PPD (n=90) 0.1 ml in the largest wart once in 2-weeks till there is complete clearance or maximum of five injections whichever is earlier. Patients were followed at 4 week after last injection for assessment of response, adverse effects, and recurrence of common warts. Results: Complete, partial clearance and no response in 51.2%, 45.3% and 2.3% children was observed in intradermal group as compared to 54.2%, 42.5% and 1.1% response in intralesional group respectively. Recurrence of warts was observed in 1.2% and 2.2% children in intradermal and intralesional group respectively. Pain was the most common adverse effect in both groups followed by erythema lasting for 2-3 days not warranting for discontinuation of treatment in any patient. Conclusion: Overall 96.5% and 96.7% patients in both intradermal and intralesional group responded to treatment respectively. We conclude that immunotherapy with PPD appears safe, effective, and acceptable treatment modality for common warts in children. Although intralesional group showed slightly higher efficacy for warts (0.2%), intradermal PPD has advantage of less pain, high patient satisfaction, less spillage of injection material onto surroundings and better compliance over intralesional group and hence can be considered as valuable first line treatment in children in resource poor developing countries.   Keywords: Intradermal, Intralesional, Immunotherapy, Purified Protein Derivative, Warts.

Article Details

Abstract

Introduction: Commonly used destructive treatment modalities for treatment of warts though effective, are associated with pain, pigmentary changes, scarring and recurrences. Utilization of various vaccines and skin test antigens has broaden the horizon of available immunotherapeutic armamentarium for the treatment of warts. Aim: Evaluation of efficacy and safety of intradermal PPD for treating facial warts - a prospective study.. Materials and Methods: Fifty-four patients with facial warts were treated with intradermal injections of PPD 10 TU/0.1 ml at two weekly intervals. They were followed up at 2, 4, 6, 8, and 12 weeks for assessment of response, adverse effects and recurrence of facial warts. Results: Out of 54 (M: F 25:29) patients, only 49 patients with facial warts completed the study. Overall, complete clearance in 22(45%) patients and partial clearance in 18(37%) patients were observed. The patients with complete/partial clearance were highly satisfied from the treatment. Recurrence was not seen in our patients. Few patients had injection site pain for 2-3 days not warranting discontinuation of treatment. Other adverse effects included temporary erythema and swelling in 3 patients which subsided on its own in 2-3 days. Conclusion: 82% patients responded (complete and partial response) to therapy. Intradermal PPD appears effective, safe, and acceptable treatment modality for facial warts. It carries the advantage of patient compliance, insignificant adverse effects and high patient satisfaction. Keywords: Warts, Purified protein derivative, Intradermal, Immunotherapy.

Article Details

Abstract

Background and Aims: Myriad of therapeutic modalities for warts are available but none promises complete response. Despite adequate treatment, the virus may persist in the surrounding tissues leading to recurrence. Immunotherapy is considered better than destructive options where there are multiple lesions, extensive involvement and is best suitable for paediatric patients. The aim of the study was to evaluate the efficacy and safety of intralesional BCG vaccine in the management of cutaneous warts (common warts, plantar and periungual warts). Materials and Methods: Patients of age 12 years and above clinically diagnosed with cutaneous warts and presenting consecutively in the outdoor clinic of Dermatology, Venereology & Leprosy Department of Dr. R.P. Govt. Medical College, Kangra at Tanda, Himachal Pradesh between June 2021 to May 2022 were enrolled. BCG vaccine was administered into the largest wart intralesionally and the injection was repeated every 3 weeks for a maximum of four injections or till the complete clearance of warts, whichever was earlier. The efficacy was assessed every 3 weeks and patients were followed up at 3 and 6 months. Observations: Majority of patients were in the age group of 14-53 years. The study showed therapeutic response in 35.08% (20/57) patients and partial response in 63.15% (36/57) patients while there was no response in 1.75% (1/57) patients at the end of 12 weeks with a very low recurrence rate (5.2%). Plantar warts have responded excellently showing complete clearance in 91.5% and partial response in 9.5% of the patients followed by palmar warts achieving complete response in 60% and partial response in 40% of the patients. Conclusion: The reconstituted BCG immunotherapy is a cheap, effective and easily available therapeutic option which can easily be practised routinely. However, due its considerable adverse effects as compared to other immunotherapeutic agents, we do not recommend it to be the first line agent.   Keywords: Bacille Calmette- Guerin, Intralesional immunotherapy

Article Details