title: Bone mineral density in patients with alopecia areata treated with long-term intralesional corticosteroids.
abstract: BACKGROUND
  Intralesional corticosteroid injections are a common treatment for patchy alopecia areata, the most prevalent subtype of this autoimmune hair disorder. To date, no studies have examined the potential adverse effects of this therapy on bone mineral density (BMD).
  
  
  METHODS
  In this retrospective, cross-sectional case series, 18 patients with patchy alopecia areata treated at 4- to 8-week intervals with intralesional triamcinolone acetonide for at least 20 months were evaluated for BMD using dual-energy x-ray absorptiometry (DXA). Follow-up DXA measurements were obtained in those with abnormal findings.
  
  
  RESULTS
  Nine out of 18 patients (50%) had abnormal DXA results. Patients with the following risk factors were more likely to have abnormal BMD: age older than 50 years, body mass index less than 18.5 kg/m2, lack of weight-bearing exercise, smoking history, postmenopausal status, past stress fracture, family history of osteopenia or osteoporosis, and a cumulative intralesional triamcinolone acetonide dose of greater than 500 mg.
  
  
  CONCLUSIONS
  Patients with patchy alopecia areata who receive chronic intralesional triamcinolone acetonide therapy should be counseled on preventive measures for osteoporosis and monitored for effects on BMD.
authors: Department of Dermatology, University of California, San Francisco, CA , USA.
authors: Aman
authors: A
authors: Samrao
authors: Jennifer M
authors: JM
authors: Fu
authors: Steven T
authors: ST
authors: Harris
authors: Vera H
authors: VH
authors: Price
mesh_terms: D015502:Absorptiometry, Photon; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use*; D000328:Adult; D000367:Age Factors; D000368:Aged; D000506:Alopecia Areata / Q000188:drug therapy*; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use*; D015519:Bone Density / Q000187:drug effects*; D001851:Bone Diseases, Metabolic / Q000235:genetics; D002118:Calcium / Q000008:administration & dosage / Q000627:therapeutic use; D019587:Dietary Supplements; D005138:Eyebrows / Q000473:pathology; D005260:Female; D015775:Fractures, Stress / Q000150:complications; D006801:Humans; D015552:Injections, Intralesional; D008297:Male; D008875:Middle Aged; D017698:Postmenopause; D011241:Prednisone / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D012307:Risk Factors; D012535:Scalp / Q000473:pathology; D057185:Sedentary Behavior; D012907:Smoking / Q000009:adverse effects; D013131:Spine / Q000033:anatomy & histology; D014221:Triamcinolone / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D014807:Vitamin D / Q000008:administration & dosage / Q000627:therapeutic use; D014815:Vitamins / Q000008:administration & dosage / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones; D000893:Anti-Inflammatory Agents; D014815:Vitamins; D014807:Vitamin D; D014221:Triamcinolone; D002118:Calcium; D011241:Prednisone