Pulse methylprednisolone therapy for the treatment of extensive alopecia areata

Background: Since the mainstay of pathogenesis depends on autoimmune process, systemic steroids are widely used in the treatment of alopecia with various side effects. To avoid side effects of long-term steroid treatment, pulse methylprednisolone therapy appears to be a safe treatment option. Objective: The aim was to determine the effect of pulse methylprednisolone therapy for the treatment of adult alopecia areata. Methods: Demographical features of all patients were recorded before the treatment. Patients received methylprednisolone 500 mg intravenously for 3 consecutive days every month for 3 months. Patients were followed up for 3 months. Treatment responses were defined by complete regrowth (100%), significant regrowth (>50%) and minimal regrowth (<50%). Results: Totally 15 patients were enrolled in this study. At the end of the study, two patients had significant regrowth and one patient had minimal regrowth in multifocal alopecia areata (n = 4); one patient had significant regrowth and one patient had minimal regrowth in alopecia universalis (n = 8); three patients had no regrowth in alopecia totalis (n = 3). Conclusions: The study suggests that pulse methylprednisolone therapy might be a therapeutic option for severe multifocal alopecia areata. However, in alopecia totalis or universalis, treatment results are unsatisfactory.