COMPARATIVE EVALUATION OF THE EFFICACY OF TOPICAL CALCIPOTRIOL 0.005% MIXED WITH BETAMETHASONE DIPROPIONATE VERSUS TOPICAL CLOBETASOL PROPIONATE 0.05% IN THE TREATMENT OF ALOPECIA AREATA: A CROSS-SECTIONAL STUDY

Abstract

Purpose: Alopecia areata is an autoimmune disorder of non-scarring hair loss having the the potential to cause significant psychological distress and low quality of life. Although potent topical corticosteroids, e.g., clobetasol propionate, are often used, their application is partly because of local adverse effects. Vitamin D analogs have recently gained increased attention as a basis for the development of combination regimens. In particular, calcipotriol 0.005% in combination with betamethasone dipropionate (BDP) has been shown to possess the potential for interaction and effects, including immunomodulation and promotion of hair cycle cycling.  Background: The aim was to compare the clinical and trichoscopic outcomes of the patients with alopecia areata who received topical calcipotriol 0.005% and betamethasone dipropionate versus topical clobetasol propionate 0.05% in cross-sectional analysis. Participants and methods: 80 adult (18 to 60 years) patients with a diagnosis of clinically and trichoscopically confirmed alopecia areata were enrolled and maintained on any treatment for ≥6 months (January 2024 to June 2024). The participants were divided into two groups: Group A (n = 40) received calcipotriol/betamethasone combination therapy, and   B (n = 40) received clobetasol propionate monotherapy. Data (including current Severity of Alopecia Tool score, trichoscopic parameters (termirnal hair density, mini attributed/vellu hair count, perifollicular inflammation), patient satisfaction using VAS score (0 to 10), and adverse events) were collected at a single evaluation visit. Results: Group A patients mean SALT score was significantly lower and terminal hair density was higher than those in Group B (p < 0.05). Combination therapy reduced the number of miniaturized hairs and the degree of inflammation compared with the other groups. There was a significant difference in patient satisfaction with Group A, (mean VAS score of 8.1) versus Group B (mean VAS score of 7.2; p = 0.02), based on mean VAS score. The rate of mild, transient local irritation was similar for the two groups. What we concluded from the data provided by this   study is that the combination of topical calcipotriol 0.005% and betamethasone dipropionate is superior to clobetasol propionate as a therapy in alopecia areata. These findings support the usage of vitamin D analog combination therapy as an effective alternative to routine clinical practice.