triamcinolone acetonide (Azmacort 134a / KI03216 / Azmacort CFC)

Comparison of Platelet-Rich Plasma Therapy Versus Intralesional Triamcinolone Acetonide in the Treatment of Alopecia Areata: A Single-Blinded, Randomised Controlled Trial.

Sethi Yashika Y, Dabas Garima G, Yadav Pravesh P, Sagar Vivek V et al.

The management of alopecia areata is often challenging. Available treatment modalities include intralesional triamcinolone, topical steroids, and immunotherapy to name a few. The current study was designed to compare the efficacy, safety, and patient satisfaction of platelet-rich plasma (PRP) versus intralesional triamcinolone acetonide (IT) (10 mg/ml) given 3-weekly for 3 doses in the treatment of localised alopecia areata of the scalp. This was a single-blind, randomised controlled study wherein 60 patients with localised alopecia areata of the scalp were enrolled. Thirty patients each received either IT or PRP therapy at 3 weekly intervals for 3 sessions at 0, 3, and 6 weeks, and follow-up was done at 9 and 18 weeks. The response was assessed using the mean severity of alopecia tool score (SALT) score, SALT score reduction, regrowth of fully pigmented hair, hair regrowth grade scale, complete regrowth, side effect profile, and patient satisfaction scale. The mean SALT score in IT and PRP groups at baseline was 4.04 ± 2.19 and 3.92 ± 2.22, respectively. The mean SALT scores in IT and PRP groups decreased to 2.22 ± 1.74 and 1.46 ± 3.25, respectively (P = 0.625) at 9 weeks follow-up. The percentage reduction in mean SALT score in IT and PRP groups was 54.86 ± 44.4 and 48.77 ± 56.5, respectively (P = 0.976) at 9 weeks. The percentage of patients showing complete regrowth was higher in the IT group (P = 0.292), while regrowth of fully pigmented hair was more frequent in PRP group (P = 0.272), although both were not statistically significant. Pain and bleeding were more frequently reported in the PRP group. Atrophy and telangiectasia were exclusively seen in the IT group. The patient satisfaction score (PSS) was similar in both groups (P = 0.691). Platelet-rich plasma therapy was as effective as intralesional triamcinolone acetonide (10 mg/ml) in treating patients of localised alopecia areata. Clinical Trials Registry of India number CTRI/2023/01/048750 [Registered on: 04/01/2023].

Incidence and Management of Ocular Hypertension Following the 0.19 mg Fluocinolone Acetonide Implant for Diabetic Macular Edema.

Farrell Lily C LC, Gomes Isabella V Y IVY, Zafar Sidra S, Muste Justin C JC et al.

To investigate the real-world incidence and management of ocular hypertension (OHT) following the intravitreal 0.19 mg fluocinolone acetonide implant (FAi, Iluvien) for diabetic macular edema (DME). Retrospective review of eyes treated with FAi (2015-2025) with ≥1 month follow-up. Primary outcome was OHT (IOP >25 mmHg). Secondary outcomes included IOP >30 mmHg, IOP rise ≥10 mmHg from baseline, and OHT management. A total of 118 eyes (90 patients) were included with mean follow-up of 33.1 ± 1.3 months. Mean baseline IOP was 14.0 ± 3.0 mmHg. Pre-existing glaucoma or OHT was present in 32.2% of eyes, and 78.8% had a prior periocular or intravitreal corticosteroid injection. Overall, 11 eyes (9.3%) developed OHT (IOP >25mmHg) following FAi. Peak IOP >30 mmHg occurred in 6 eyes (5.1%), and 12 eyes (10.2%) had an IOP rise ≥10 mmHg above baseline. OHT developed at variable time points, with 36.4% of cases occurring between 6-12 months and 27.3% after 24 months; mean time to OHT development was 15.6 ± 13.1 months. Higher baseline IOP was associated with increased odds of developing OHT (OR per 1mmHg increase 1.32, p=0.02). Of the 11 eyes with OHT, most were managed medically (63.6%) or with observation (36.4%) alone, with only 1 eye (9.1%, 0.8% of entire cohort) requiring incisional glaucoma surgery. FAi was associated with low rates of OHT, with most cases managed with observation or topical therapy, with surgery rarely required. This supports the safety of FAi and highlight the importance of extended IOP monitoring.

Care and outcome of a child with erythema multiforme complicated by secondary bacterial infection: a case report.

Li Nannan N, Zhang Zhe Z, Lu Yujie Y, Wu Huanling H et al.

Erythema multiforme (EM) is an acute mucocutaneous disorder usually triggered by infections. Chemical injury with secondary bacterial infection is a rare trigger in children. We report an 11-year-old boy who initially had a punctate oral ulcer, in whom overnight buccal metronidazole likely caused additional chemical irritation, followed by secondary Staphylococcus aureus infection and a subsequent diagnosis of EM. Laboratory findings revealed a marked decrease in CD4+ T cells (185/μL) and a reduced CD4/CD8 ratio (0.66). Lesions progressed from the oral cavity to the extremities, with severe lip and oral involvement. Initial burn-based wound care was ineffective. Following diagnosis, a structured wound care protocol was implemented, consisting of sequential topical ethacridine lactate, mupirocin, compound triamcinolone acetonide, and recombinant human epidermal growth factor, with continuous low-flow oxygen. The lesions improved markedly, lip ulcers healed, oral function returned, and the patient was discharged well. This case underscores the need for early EM recognition in children with atypical oral lesions and describes a structured, multistep nursing strategy that was used in this case.

Management of anterior nodular scleritis in pregnancy with subtenon triamcinolone injection.

Sahoo Sonali S