High-dose intravenous corticosteroid pulse therapy in alopecia areata: own experience compared with the literature

Abstract

Background: Seven prospective studies including 193 patients have been published on high-dose intravenous corticosteroid pulse therapy in alopecia areata (AA). We compare these data with a retrospective analysis of our own consecutive patients.

Patients and methods: Between 1998 and 2002,25 patients with severe AA were treated at the Department of Dermatology, University of Bern, with infusions of 500 mg methylprednisolone on 3 consecutive days. In addition to the inpatient records, in 2004 all patients were followed up by a questionnaire.

Results: Four of 10 patients with multifocal AA and 3 of 9 patients with ophiasis-type AA had full re-growth of hair, whereas all 6 patients with AA totalis/universalis failed to respond.

Conclusion: Intravenous corticosteroid pulse therapy may be helpful in the treatment of multifocal and ophiasis-type AA. Patients with an initial episode of short duration have better chances for success.