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Background:   Treatment of resistant alopecia totalis AT is a major problem in general practice.  Some studies reported the use of either excimer-308 or intra-muscular triamcinolone acetonide as a monotherapy, with conflicting results.  Objective: To evaluate the therapeutic effect of combining 308-excimer phototherapy and intramuscular triamcinolone acetonide for the treatment of alopecia totalis.  Methods and Material: Ten patients with alopecia totalis were evaluated in this prospective interventional study. All patients were assigned to receive the thera-peutic regimen that includes monthly IM triamcinolone acetonide (TAC) for a maximum of six pulses and twice-weekly excimer phototherapy for 24 sessions.  Results:  The overall response rate for this regimen was 90%, with four patients 40% achieving complete regrowth of hair (100%). Three patients have exhibited a satisfactory response (&gt;70% regrowth). Unsatisfactory response ( &gt;10-&lt; 70% regrowth) was reported in two patients . Younger patients responded better, as did those with a shorter history of the disease P &lt; 0.05.  At follow-up, which continued for 8–12 months, recurrence was noted in two (22.2%) of the nine responders.  Conclusions:  Combining excimer phototherapy with triamcinolone acetonide showed a promising effect on resistant AT. This treatment modality was effective and well tolerated particularly in young patients.

Combining 308-monochromatic excimer phototherapy with monthly IM triamcinolone acetonide for the treatment of resistant alopecia totalis