الفهرس 
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Abstract
This study was conducted at the Department of Dermatology, Venerology and Andrology, Assiut university Hospital, Egypt, in the period (from September 2016 to October 2018) to evaluate the efficacy of PRP and microneedling in the treatment of alopecia areata. Thirty alopecia areata patients were recruited from the outpatient clinic of the Depertment of Dermatology, Venerology and Andrology, Assiut university hospital. Patients were classified into three group: group I included 10 patients were treated with microneedling using dermapen and intradermal PRP injection. group II included 10 patients were treated with PRP microinjections using insulin syringes. group III included 10 patients were treated with microneedling by dermapen. This was done monthly for four sessions with the final evaluation was done one month after the last session. The response to treatment was assessed with photographs taken for the patient before every session and one month after the last one, along with SALT score and dermoscopic evaluation at the baseline and one month after the last session. The percent of improvement in the dermoscopic examination was graded by evaluating the percentage of dystrophic hairs by using four grades of improvement: 3, > 50%; 2, 30–50%; 1, 1–29%; 0, no dystrophic hairs. The participating patients in the study were 23 male and 7 females with age ranged from 14 - 45 years with mean age of group1 was 26.4 ± 5.5, mean age of group II was 30.9 ± 10.2 and mean age of group3 was 21.6 ± 10.3. Eight patients in group I and II and seven patients in group3 were males while two patients in group I and II and III patients in group III were females. Stress was the most triggering factor in all groups, it was 70%, 90%, 100% respectively. No previous treatment of AA was reported in most patients in the three groups, it was 60% in group I and 70% in group II and group 3. Twenty two of studied AA patients in the three groups had single patch only while eight of studied AA patients had multiple patches. There was significant decrease in the SALT score and dystrophic hairs from the baseline after treatment with both PRP and microneedlig. Evaluation of the degree of improvement in the dermoscopic examination after treatment revealed that seven (70%) patients showed regrowth of hair (no dystrophic hairs)and 3 (30%) patients showed no hair regrowth (> 50 % dystrophic hairs). There was no significant difference (p-value > 0.05) in the SALT score and statistically significant decrease (p-value < 0.05) at dermoscopic examination of AA from the baseline after treatment with PRP only. The mean value of SALT score in group II was 2.3± 1.2 before treatment while it was 1.8 ± 1.2 after treatment. Dermoscopic evaluation of AA in patients of group II showed that, dystrophic hairs in all patients were > 50 % before treatment while after treatment five (50%) patients showed 1-29% dystrophic hairs, two (20%) patients showed 30-50% dystrophic hairs and three (30%) patients showed no hair regrowth (> 50 % dystrophic hairs). There was no statistically significant difference (p-value > 0.05) in the SALT score and dermoscopic examination of AA from the baseline after treatment with microneedling only. The mean value of SALT score in group III was 2.8± 4.3 before treatment while it wsa 2.7 ± 4.4 after treatment. Dermoscopic evaluation of AA in patients of group III showed that, dystrophic hairs in all patients were > 50 % before treatment while after treatment two (20%) patients showed 1-29% dystrophic hairs and eight (80%) patients showed no hair regrowth (> 50 % dystrophic hairs). The three techniques used for AA treatment in the present study was associated with no statistically significance difference in SALT score between the three groups as all patients still in S1 grade in SALT score ,P-value was 0.2. However an individual difference in each group was found before and after treatment. In dermoscopic evaluation of AA after treatment, highly statistically significant difference (p-value < 0.001) were detected between the three groups. As regards the degrees of patients’ satisfaction, 70% of patients in group I were very satisfied while 30% of patients were unsatisfied. 30% of the patients of group II were very satisfied and also 30% were unsatisfied. None of patients of group III were very satisfied while 80% of patients were unsatisfied.