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PRP therapy in chronic diffuse alopecia areata – A case report

Alopecia areata, an auto-immune disorder characterised by the appearance of non-scarring bald patches affecting the hair bearing areas of the body, it can be extremely difficult to treat and has a poor prognosis despite many therapeutic options. Platelet Rich Plasma (PRP) has been previously used to treat variety of alopecia including alopecia areata. A 21-year old girl presented with asymptomatic loss of hair from the scalp for the last more than two years. On examination, there was diffuse loss of hair all over the scalp with few small, thin light-coloured hair in the occipital region. Histopathological examination showed miniaturised hair follicles surrounded by variable inflammatory lymphohistiocytic infiltrate with a marked reduction in terminal-vellus hair ratio to 1:1.The response to previous treatments was poor at the end of 1 year. A trial of PRP was given with no adjuvant treatment with a total of eight sessions of PRP. Dramatic response was noted after 2 sessions in the form of improvement in hair diameter and total volume. Resistant areas also started showing hair growth. There are a few studies assessing the role of PRP therapy in AA. First report to establish the efficacy of PRP as a treatment modality in AA, showed PRP therapy to be superior to TCA and Placebo in growing pigmented hair in AA patches. A case report with ophiasis type AA resistant to intralesional steroid injections showed excellent response to PRP therapy. Previous studies have demonstrated beneficial role of PRP therapy in cases of patchy alopecia areata, in contrast ours was a case of chronic diffuse AA. Inspite of many treatment modalities tried for more than a year, the response was unsatisfactory. PRP therapy yielded amazing results in the form of hair growth over resistant areas and overall increase in pigmented hair which were sustained at one and a half year follow up. Our case was unique in the way that excellent response to PRP treatment was noted (a) In a case of diffuse alopecia areata. (b) In a case non- responsive to standard modalities. (c) In a case with no other supportive treatment.