The Efficacy of Oral Medium Dose Prednisolone Pulse Therapy for Acute and Chronic Alopecia Areata Diffuse Type

Abstract

Although various therapeutic strategies for alopecia areata (AA) have been described, they are still limited, suboptional, and not curative or preventive. We sought to evaluate the efficacy of oral medium-dose prednisolone (PSL)-pulse therapy in patients with progressive AA. Briefly, nine new-onset progressive AA patients and 4 progressively recurrent AA patients who had been under SADBE treatment were treated with 0.5 mg/kg/day PSL for 3 days every 2 weeks for 3-5 courses. In recurrent cases, PSL was administrated on day 4 after the topical SADBE therapy. Significantly, none of patients discontinued the treatment due to side effects. Two of the new-onset AA patients had great responses with terminal hair; no further therapy was needed. Four of the new-onset AA also had significant improvements with later additional SADBE treatment. On the other hand, although 3 of 4 recurrent patients grew vellus hair after the PSL therapy, none of them was finally considered to be improved. In conclusion, because it has fewer side effects, oral PSL-pulse treatment may be a useful therapeutic option for progressive AA.