title: Combination therapy of cyclosporine and methylprednisolone on severe alopecia areata.
abstract: 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.
authors.affiliation: Department of Dermatology, College of Medicine, Chung Ang University, Seoul, South Korea.
authors.forename: Beom Joon
authors.initials: BJ
authors.lastname: Kim
authors.forename: Seong Uk
authors.initials: SU
authors.lastname: Min
authors.forename: Kui Young
authors.initials: KY
authors.lastname: Park
authors.forename: Jung Won
authors.initials: JW
authors.lastname: Choi
authors.forename: Sung Wook
authors.initials: SW
authors.lastname: Park
authors.forename: Sang Woong
authors.initials: SW
authors.lastname: Youn
authors.forename: Kyoung Chan
authors.initials: KC
authors.lastname: Park
authors.forename: Chang Hun
authors.initials: CH
authors.lastname: Huh
mesh_terms: 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
chemical_list: D000893:Anti-Inflammatory Agents; D003879:Dermatologic Agents; D016572:Cyclosporine; D008775:Methylprednisolone