F9 GUIDELINE FOR METHYLPREDNISOLONE PULSE THERAPY OF ALOPECIA AREATA
Im M, Seo YJ, Lee JH, Park JK
Department of Dermatology, College of Medicine, Chungnam National University, Deajon, Korea

Methylprednisolone pulse therapy has been widely used to treat severe alopecia areata. This is a desirable method for increasing therapeutic effect and avoiding side effect of long-term steroid administration. But, there is no information which is the most proper criteria for pulse therapy. The purpose of our study was to establish a guideline for methylprednisolone pulse therapy of alopecia areata. We performed a clinical study of 70 patients with severe alopecia areata who were treated with intravenous methylprednisolone 25mg/kg/day (up to 1000mg/day) on three consecutive days. The response to therapy was evaluated serially using the clinical grading by photography and hair examination by microscopy. As the result, factors that influence to the therapeutic effect were disease duration before treatment and alopecia areata type. According to these two factors, we prepared guidelines for methylprednisolone pulse therapy of severe alopecia areata. Absolute indication is a less than 3 months' duration of alopecia totalis or universalis and 4 - 6 months' duration of actively progressive multifocal alopecia. Relative indication is a 4 - 6 months' duration of alopecia totalis or universalis and 7-12 months' duration of multifocal alopecia. In conclusion, methylprednisolone pulse therapy appears to be well tolerated and effective in patients with rapidly progressing extensive alopecia areata, i.e. alopecia totalis or universalis within 3 months of onset duration, and multifocal type within 6 months of onset duration.