الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Alopecia areata (AA) is a common cause of inflammatory, immune mediated, non-scarring hair loss with an overall prevelance about 2.11% ,and a life time risk of 2% world wide. There is a significant variation in the clinical presentation of AA, ranging from well-circumscribed round or oval patches of hair loss on the scalp, to complete loss of scalp and body hair.
Although AA is not life threatening condition, psychological comorbidities are common and result in marked impairment in patients’ well-being and self-esteem.
Dermoscopy has become a valuable, non invasive diagnostic tool especially in doubtful cases of AA. The dermoscopic features of AA differ according to the stage, site and severity of the disease.
Yellow dots, black dots, broken hairs, exclamation mark hair (tapering hairs) and short vellus hairs are the most common dermoscopic features of alopecia areata.
Yellow dots and short vellus hairs are the most sensitive findings for the diagnosis of alopecia areata. While, Black dots, tapering hairs and broken hairs are the most specific findings and correlate with the disease activity.
Features indicating hair regrowth are pigmented short upright regrowing hairs and coiled pigtail hairs.
A number of treatments have been described to induce hair regrowth in AA like topical, systemic, and intralesional corticosteroids; minoxidil; topical immunotherapy; anthralin; and photo¬chemotherapy.
Fractional lasers have been implicated for hair regrowth in some hair disorders as alopecia areata, male pattern hair loss, and female pattern hair loss through their effect in induction of T-cell apoptosis stimulating re-entry of telogen to anagen hair follicles, thereby prolonging the duration of the anagen phase, and direct enhancement of hair growth by the dermal heat produced.
In addition to their direct therapeutic effect, fractional lasers also act through transepidermal drug delivery (TED) of the topical medications into the hair follicle. This property is known as “laser-assisted drug delivery”.
LADD is a technique that uses ablative fractional lasers to produce channels of microthermal zones (MTZs) of different depths and placing a drug or molecule topically, immediately following the procedure. This method allows more uniform distribution and deeper penetration of the drug in a predictable and controlled pattern with minimal skin damage or discomfort.
This work aimed at comparing the effect of fractional carbon dioxide laser assisted topical steroid delivery with intralesional steroid injection in the treatment of alopecia areata.
This study was carried out on thirty subjects with two or more patches of alopecia areata (60 patches of AA), recruited from the outpatient clinic of Dermatology, Venereology and Andrology Department, Main University hospital, Alexandria Faculty of Medicine. The thirty patients were clinically examined; In addition to clinical evaluation, digital clinical and dermoscopic photographs were taken at baseline and at each follow-up visit to document clinical response.