Evaluation of the Effect of Topical Calcipotriol Versus Platelet-Rich Plasma
Condition: Alopecia Areata
MeSH terms: Alopecia; Alopecia Areata
Study type: Interventional

Summary: 
      Alopecia areata (AA) is a common, immune-mediated non scarring alopecia and can be associated
      with severe psychological consequences . Alopecia Areata affects 2% of the global population.
      Alopecia Areata prevalence is lower in adults than children, is increasing over time, and
      significantly differs by region.

      Its etiology is unknown but it was hypothesized to be an autoimmune disease mediated by
      T-lymphocytes. It has been suggested that inflammatory T cells induce growth arrest in hair
      bulbs in the anagen phase of the hair cycle . Cytotoxic T cells secrete tumor necrosis
      factor, granzymes, and Fas ligand which trigger apoptosis in affected hair follicle and
      disrupt hair growth
    

Detailed description: 
      Clinically, Alopecia Areata presents as a well-circumscribed patch of sudden hair loss. It
      affects any hair bearing area. The most common affected site is the scalp .

      Dermoscopy is a highly valuable tool in diagnosis and follow-up of Alopecia Areata. The most
      common trichoscopic features of Alopecia Areata are yellow dots, micro exclamation mark
      hairs, tapered hairs, black dots, broken hairs, and regrowing upright or regrowing coiled
      hairs .

      The diagnosis of alopecia areata is commonly established based on clinical appearance, In
      cases of ambiguity, trichoscopy may be useful to avoid invasive procedures such as biopsy.

      Treatment of alopecia areata is dependent on age of patient as well as the extent and
      duration of scalp involvement. Treatments include steroids, topical immunotherapy, topical
      minoxidil, anthralin, and immunosuppressants. Each case must be dealt with on a customized
      individual basis.

      Platelets rich plasma (PRP) is an autologous preparation of platelets in concentrated plasma.
      Injection of PRP improves cutaneous ischemic conditions, increases vascular structures around
      hair follicles and induces the proliferation of dermal papilla cells by up regulating
      fibroblast growth factor 7 (FGF-7) .Anagen-associated angiogenesis has been suggested as one
      of the important factors in active hair growth, due to the secretion of vascular endothelial
      growth factor by the keratinocytes of the outer root sheath and fibroblasts of the dermal
      papilla .

      Topical calcipotriol is a vitamin D analogue that regulates keratinocytes proliferation and
      differentiation. It can induce hair regrowth in Alopecia Areata lesions by regulation of the
      differentiation of B cells, T cells, dendritic cells, and Toll-like receptor expression.
      There are few reports evaluating the effect of calcipotriol in Alopecia Areata .

      Patients with Alopecia Areata are characterized by an abnormal serum level of adipokines,
      particularly adiponectin and resistin. Adiponectin may be considered as a marker of severity
      of hair loss in alopecia areata. Impaired secretion of specific adipokines may play an
      important and complex role in the pathogenesis of Alopecia Areata and its continuity
    

Intervention name(s): Calcipotriol
Intervention type(s): Drug
Intervention description(s): To evaluate the efficacy of Calcipotriol on Alopecia Areata.
Other intervention name(s): Platelet Rich Plasma
Intervention MeSH terms: Calcipotriene
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Triple (Participant, Investigator, Outcomes Assessor)
Primary purpose: Treatment