Combination therapy of cyclosporine and methylprednisolone on severe alopecia areata.
BACKGROUND
Although systemic cyclosporine appears to be one of the treatment options for chronic severe alopecia areata (AA), the high recurrence rates after discontinuation and side effects make cyclosporine a nominal agent for the treatment of AA.


OBJECTIVE
This study was designed to determine whether the combination therapy of cyclosporine and methylprednisolone could be an effective treatment for severe AA.


METHODS
A total of 46 patients with severe AA were treated with a combination of cyclosporine (200 mg twice daily, two 100 mg tablets) and methylprednisolone (24 mg twice daily for men, 20 mg twice daily for women, and 12 mg twice daily for children). The doses of methylprednisolone were diminished by 4 mg/day weekly, and the dose of cyclosporine was decreased gradually after cessation of administration of methylprednisolone.


RESULTS
Three (6.5%) of 46 patients discontinued the treatment due to side effects. Of the remaining 43 patients, 38 (88.4%) had significant hair regrowth and five (11.6%) were considered to be treatment failures. Nine (23.7%) relapsed during the observation period of 12 months.


CONCLUSIONS
Although limited by its uncontrolled character, this study shows that combination therapy with cyclosporine and methylprednisolone may be a useful treatment for severe AA.
Kim
Beom Joon
BJ
Department of Dermatology, College of Medicine, Chung Ang University, Seoul, South Korea.
Min
Seong Uk
SU
Park
Kui Young
KY
Choi
Jung Won
JW
Park
Sung Wook
SW
Youn
Sang Woong
SW
Park
Kyoung Chan
KC
Huh
Chang Hun
CH
D000293:Adolescent; D000328:Adult; D000368:Aged; D000506:Alopecia Areata / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D002648:Child; D015331:Cohort Studies; D016572:Cyclosporine / Q000008:administration & dosage*; D003879:Dermatologic Agents / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage*; D008875:Middle Aged; D055815:Young Adult
D000893:Anti-Inflammatory Agents; D003879:Dermatologic Agents; D016572:Cyclosporine; D008775:Methylprednisolone