درمان آلوپسي آراتاي وسيع و مقاوم به روش پالس تراپي با كورتيكو استروييد خوراكي

Pulsed Administration of Corticosteroids in Treatment of Alopecia Areata

Introduction: Background: Widespread Alopecia Areata (AA) is difficult to treat and modalities such as topical and systemic steroids, topical sensitizers (e.g. squaric acid dibuty lester and diphencyprone), psoralen-ultraviolet A (PUVA) therapy, minoxidil, and immunomodulators have been tried. Material and Methods: Patients with widespread AA (> 40% scalp involvement), including Alopesia Totalis (AT) and universalis (AU) were treated with 300 mg oral prednisolone pulsed at month intervals, for a minimum of 4 doses or until cosmetically acceptable hair growth was obtained. Response to therapy was monitored by clinical assessment and patients were examined monthly for sideffects ofsteroids. Result: Seventeen patients (12 men, 5 women) with a mean age of 23.8 years (11-50 years) were recruited. They had alopecia for a mean period of 5.5 years (l-16y).10 patients (4AA, IAT, 5AU) received 300mg pulse therapy at least for 4 months. 2 (20%) patiens (2AU) out of 10 evaluated treated, showed cosmetically acceptable hair growth, response was evident on average after 3 months and cosmetically acceptable at 5 months. Side effects were surprisingly rare and mild. Conclusions: An oral monthly pulse of prednisolone 300 mg is safe and can be administered on an out patient basis. Although good efficacy of oral pulse therapy in the treatment of extensive AA previously has been reported, but the result of our study was not as effective as their, and there is requirement for more studies especially in selective patients.