P7.79 CORRELATION BETWEEN DISEASE DURATION AND THE EFFECT OF METHYLPREDNISOLONE PULSE THERAPY FOR ALOPECIA AREATA

Jang Kyu Park, Myung Im, Min Su Park, Young Joon Seo, Jeung Hoon Lee

Department of Dermatology, College of Medicine, Chungnam National University, Teajon, Korea

Backround: Many treatments have induced remission in patients with alopecia areata. Among them, systemic steroids may be effective in the treatment of severe alopecia areata but have many side effects. To avoid side effects, high dose bolus infusions of methylprednisolone have been used to treat severe alopecia areata.

Objectives: Our purpose was to determine the difference in the effect of intravenous pulse therapy of methylprednisolone in relation to disease duration.

Methods: We performed a clinical study of 40 patients with severe AA whose disease duration was 1,3,6,12,24 months or more. Patients were treated with methylprednisolone intravenously 1000mg/day (750mg: 8AM, 250mg: 4PM) on 3 consecutive days. Response to therapy was graded using the following scale; CR(complete response) meaning no problems with cosmetic appearance, PR(partial response) meaning terminal hair but cosmetic appearance not acceptable, and NR(non response) meaning only transient vellus hair.

Results: In patients with 1~3months disease duration, 100 %(8 of 8) patients showed CR;  with 4~6months , 71.4 %(5 of 7) showed CR and 28.6%(2 of 7) showed PR; with 7~12months, 28.6 %(2 of 7) showed CR, 42.9%(3of 7) showed PR, 28.6%(2 of 7) showed NR; with 13~24 months, 12.5%(1 of 8) showed CR, 62.5%(5 of 8) showed PR, 25%(2 of 8) showed NR; and with more than 24 months, 20%(2 of 10) showed PR, 80%(8 of 10) showed NR.

Conclusions: Disease duration before treatment is the most important prognostic factor in pulse therapy of AA. Long standing AA (more than 12 months) shows poor response to pulse therapy for alopecia areata. High-dose methylprednisolone pulse therapy is an effective and well-tolerated treatment for patients with severe alopecia areata especially when the disease is in its early active stage.