Efficacy of Methotrexate Microinfusion in Scalp Lesions of Patients with Frontal Fibrosing Alopecia: A Prospective Controlled Trial

Abstract

Introduction: Topical and systemic drugs, as methotrexate (MTX), do not control the frontal fibrosing alopecia (FFA) activity in most of the cases showing the need for new therapies. Therefore, we aimed to evaluate the effectiveness of MTX microinfusion in FFA. Methods: Prospective, controlled clinical trial, carried out with 17 volunteers with clinical and histological diagnosis of FFA. Applications of MTX by MMP® (microinfusion of drugs into the skin method) were made every 30 days, in a total of 03 applications, in the right half of the alopecia area; the other half served as a control. Results: There was a significant reduction in frontal-glabella and frontal temporoparietal measurements at treated site while in the untreated site the FFA increased. Patient’s referred improvement of pruritus and desquamation but not in hair loss and local erythema. Analysis of the dermoscopic photos and the LPPAI calculation did not show relevant changes. About 95% of the participants were satisfied or very satisfied with the results and none of them had alteration in the laboratory test results. Conclusion: The MTX application by MMP® improved symptoms associated with FFA, and the frontal-glabella and frontal temporoparietal measurements. This technique proved to be safe and well tolerated.