Fig. 3

Treatment Response Over Time According to Treatment Modalities This stacked bar chart illustrates the treatment outcomes for MD patients at 1, 6, 12, and 18 months of follow-up. The bars represent the number of patients receiving different treatment modalities: PO (oral medications), PT (oral medication and topical treatments), and ILS (additional intralesional steroid injections). Treatment outcomes are categorized as PR (Poor Response) or TR (Treatment Response). At 1 month, all 24 patients showed PR across all treatment modalities. At 6 months, a symptom improvement was observed, with 6 patients showing TR. The majority of TR patients (5 out of 6) received a combination of oral and topical treatments compared to PR patients (P = 0.033). At 12 and 18 months, the number of patients with TR decreased slightly, and the differences in treatment modalities were not statistically significant (p = 0.364 and p = 0.881, respectively). The total number of patients decreased over time, due to monitoring cessation in TR cases or loss to follow-up. This figure demonstrates the potential benefits of combination therapy, particularly at the 6-month point