title: High-dose steroid pulse therapy for the treatment of severe alopecia areata.
abstract: Growing evidence shows alopecia areata (AA) to be a T cell-mediated organ-specific autoimmune disease. This study aimed to evaluate the efficacy of high-dose steroid pulse therapy in Taiwanese patients with severe widespread AA exceeding 40% of the scalp. A total of 17 Taiwanese patients with severe AA lasting less than 2 years were treated once monthly at the outpatient clinic for six sessions. Children younger than 12 years of age received oral prednisolone (5 mg/kg) in three divided doses, while for adults, 500 mg methylprednisolone was infused intravenously over 2 hours. Patients with multifocal AA exhibited the most favorable response, with more than 75% hair regrowth (9/11). Relapse occurred in two patients at 4 and 8 months after the last treatment, respectively. One patient with ophiatic AA showed a transient response, but subsequently lost hair even upon continuation of therapy. Two patients of four with alopecia totalis had full hair regrowth but one lost hair again 6 months later. In the only patient with alopecia universalis, less than 10% hair regrowth occurred. No major side effects were observed. In summary, 11 of 17 patients (64.7%) had more than 75% hair regrowth after steroid pulse therapy. Our results indicated that steroid pulse therapy, given at 5-10 mg/kg once monthly for an average of 6 months, is effective and well tolerated in Taiwanese patients with severe multifocal AA lasting less than 2 years.
authors.affiliation: Department of Dermatology, College of Medicine, National Cheng Kung University, 138 Sheng-Li Road, Tainan, Taiwan.
authors.forename: Ya-Ming
authors.initials: YM
authors.lastname: Tsai
authors.forename: WenChieh
authors.initials: W
authors.lastname: Chen
authors.forename: Ming-Long
authors.initials: ML
authors.lastname: Hsu
authors.forename: Tzu-Kai
authors.initials: TK
authors.lastname: Lin
mesh_terms: D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D000328:Adult; D000506:Alopecia Areata / Q000188:drug therapy*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged
chemical_list: D000305:Adrenal Cortex Hormones