P#21   Methyl-prednisolone pulse therapy in treatment of severe alopecia areata

Park Min Su, Shur Ki-Beom, Lee Jeung Hoon and Park Jang-Kyu. Dept of Dermatology, Chungnam National University - School of Medicine, Taejon, Korea

The etiology of alopecia areata is unknown; however, is thought to be autoimmune disorder and systemic corticosteroids have been demonstrated as effective treatment of severe alopecia areata. But now some reports showed that systemic corticoids therapy was ineffective in alopecia totalis and universalis or long standing AA. Our purpose was to determine the effectiveness of an intravenous methyl-prednisolone pulse therapy. 17 patients with severe alopecia areata (extensive patchy, totalis, universalis types) were treated with methyl-prednisolone pulse therapy. We use intravenous methyl-prednisolone, 500mg/day, was administered a day on 3 consecutive days. Complete hair growth (group A) was obtained in 7 (41%), partial hair growth (group B) was obtained in 6 (35%) and no hair growth (group C) obtained in 4 (24%) of 17 patients. The mean duration of the disease before treatment: 1) group A: 4.9 months, 2) group B: 18.8 months and 3) group C: 66 months. So the mean duration of the disease before treatment is an important prognostic factor. No major side effects were observed. Intravenous methyl-prednisolone pulse therapy is effective, safe and can be administered on an outpatient basis, so we recommend methyl-prednisolone pulse therapy as one of the modalities in treatment of severe alopecia areata in recent onset (especially before 12 months).