38. Combined systemic therapy with cyclosporine and methyl-prednisolone in patients with extensive alopecia areata. 
Chang-Hun Huh, SW Min, CW Choi, , BJ Kim(1), SW Youn, KC Park. Dermatology, Seoul National University Bundang Hospital 1.Dong-Guk University International Hospital, Gyeonggi-do, Korea

Introduction: Alopecia areata infrequently manifest a refractory course and difficulty in treatment. Although its precise pathogenesis is unclear, a T-cell-mediated immunologic abnormalities have recently been suggested. Cyclosporine A(CsA) is an immunosuppressant originally applied in organ recipients. Nowadays, it is being used in many dermatologic conditions such as psoriasis and atopic dermatitis. Hypertrichosis, one of the common side effects of CsA, urged many physicians to prescribe it to treat alopecia areata but its efficacy is still under debate. Therefore, there is no standardized protocol of CsA in alopecia areata yet. Method: We have adapted combined systemic therapy with CsA(Cipol-N, ChongKunDang, Korea) and methyl-prednisolone (mPd, Methyron, KunWha Pharmaceutical Co., Korea) on 46 cases with extensive alopecia areata. The starting doses of CsA were varied from 2.5 mg/Kg to 4 mg/Kg and mPd, from 0.3 to 0.4 mg/Kg (4 mg of mPd = 5 mg of prednisone). After mPd was gradually tapered first, CsA was tapered next. Result: Among 46 volunteers, 43 completed the whole schedules while 3 patients were dropped out due to side effects of combination therapy(Gastrointestinal disturbance and facial edema). Among 43 cases, 5 cases did not show remarkable improvements and overall success rate was 88% (38/43). Conclusion: Combined systemic therapy with CsA and mPd may be an effective treatment modality in patients with extensive alopecia areata. But close monitoring of side effect is requisite.