Alopecia Areata
Conditions
Keywords
UV Trichoscopy, Red Fluorescence, Trichoscopy, Intralesional Corticosteroid, Hair Regrowth
Brief summary
The goal of this observational study is to learn whether red fluorescence seen with ultraviolet (UV) trichoscopy is related to disease findings and treatment response in adults with limited plaque-type alopecia areata. Trichoscopy is a close-up imaging method used to examine the hair and scalp. The study will investigate whether the amount of red fluorescence at the beginning of the study is related to how soon hair starts to grow back, how much hair regrows, and how trichoscopic findings change during follow-up. Participants for whom intralesional corticosteroid treatment has been planned as part of their regular medical care will have standard trichoscopic and UV-trichoscopic images taken of the affected scalp area. They will be followed at weeks 4, 8, and 12, when hair regrowth and changes in scalp and hair findings will be evaluated. Researchers will measure red fluorescence in the images and examine whether it is related to treatment response over time.
Detailed description
This is a prospective observational cohort study involving adults with limited plaque-type alopecia areata who are receiving intralesional corticosteroid treatment as part of routine clinical care. Participation in the study does not determine whether a patient receives intralesional corticosteroid treatment. At baseline, the affected scalp area will be evaluated using conventional polarized trichoscopy and UV-trichoscopy. Follow-up assessments will be performed at weeks 4, 8, and 12 using the same imaging approach. Trichoscopic findings of interest will include yellow dots, black dots, exclamation mark hairs, and broken hairs. UV-trichoscopic red fluorescence will be assessed quantitatively by measuring red-channel intensity on standardized digital images. Imaging and image analysis procedures will be performed using a standardized acquisition protocol to improve comparability between visits. Treatment response will be evaluated according to the appearance and extent of visible hair regrowth and the change in trichoscopic activity findings during follow-up. The main analysis will examine whether baseline red fluorescence intensity is associated with the timing and magnitude of response to intralesional corticosteroid treatment. Associations between red fluorescence intensity and baseline trichoscopic findings, as well as changes in fluorescence intensity and trichoscopic findings over time, will also be evaluated.
Interventions
DRUGTriamcinolone Acetonide
Intralesional triamcinolone acetonide is administered for limited plaque-type alopecia areata as part of routine clinical care. The decision to administer treatment is made independently of participation in this observational study. The study prospectively evaluates trichoscopic and UV-trichoscopic findings and hair regrowth during routine treatment follow-up.
Sponsors
Istanbul Training and Research Hospital
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age 18 years or older * Limited plaque-type alopecia areata of the scalp * Active hair loss * Symptom onset within the previous 6 months * No topical, intramuscular, or oral treatment for alopecia areata within the previous 1 month * No intralesional corticosteroid treatment within the previous 6 weeks * Provision of informed consent
Exclusion criteria
* Beard alopecia areata * Very extensive alopecia areata or multiple large plaques * Tinea capitis or active infection * Current phototherapy * Systemic immunosuppressive treatment within the washout period specified in the study protocol * Pregnancy or breastfeeding * Contraindication to UV imaging
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Association Between Baseline UV-Trichoscopic Red Fluorescence Intensity and Timing of First Visible Hair Regrowth | Baseline through week 12 | Baseline UV-trichoscopic red fluorescence intensity will be quantified from standardized digital images using red-channel intensity measurements. Participants will be evaluated for the first appearance of visible hair regrowth at follow-up visits at weeks 4, 8, and 12. The association between baseline red fluorescence intensity and the timing of first visible hair regrowth will be assessed. |
| Association Between Baseline UV-Trichoscopic Red Fluorescence Intensity and Degree of Hair Regrowth | Weeks 4, 8, and 12 | The degree of hair regrowth will be assessed at follow-up visits using standardized clinical photographs and trichoscopic images of the alopecic plaque. Hair regrowth will be evaluated according to the proportion of the baseline alopecic area showing visible regrowth, with trichoscopic examination used to identify early or fine regrowing hairs that may not be clearly visible in clinical photographs. The association between baseline UV-trichoscopic red fluorescence intensity and the degree of hair regrowth will be evaluated. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in UV-Trichoscopic Red Fluorescence Intensity During Follow-up | Baseline and weeks 4, 8, and 12 | UV-trichoscopic red fluorescence intensity will be quantified from standardized digital images using red-channel intensity measurements. Changes in red fluorescence intensity from baseline through follow-up visits will be evaluated |
| Change in Area-Normalized Counts of Selected Trichoscopic Findings During Follow-up | Baseline and weeks 4, 8, and 12 | Yellow dots, black dots, exclamation mark hairs, and broken hairs will be counted individually on standardized trichoscopic images. Counts will be normalized to the area of the alopecic plaque and expressed as the number of each finding per square centimeter (findings/cm²). Each trichoscopic finding will be analyzed separately rather than combined into a composite severity score. Higher values indicate a greater density of the corresponding finding. For activity-associated findings, including black dots, broken hairs, and exclamation mark hairs, a decrease during follow-up will be interpreted as a reduction in trichoscopic disease activity. Yellow dots will be evaluated separately and will not be interpreted as a direct measure of disease activity. |
| Association Between Baseline UV-Trichoscopic Red Fluorescence Intensity and Trichoscopic Findings | Baseline | The association between baseline UV-trichoscopic red fluorescence intensity and baseline trichoscopic findings, including yellow dots, black dots, exclamation mark hairs, and broken hairs, will be evaluated. |
Countries
Turkey (Türkiye)
Contacts
CONTACTSevgi Nazli Apucu, Dermatology Resident Physician
STUDY_CHAIRVildan Manav
Istanbul Training and Research Hospital
Outcome results
None listed