Treatment of alopecia areata with prednisone

BACKGROUND:
Various modalities have been used in the treatment of alopecia areata (AA), including pulsed oral corticosteroids. The aim of this study was to evaluate the efficacy and safety of pulsed oral prednisone in the management of AA.

METHODS:
This was a prospective study in patients with progressive AA affecting more than 40% of the scalp. All patients received 5mg/kg (300mg) oral prednisone once a month for 3 to 6months and were examined for adverse effects. Hair growth was classified as complete, cosmetically acceptable, incomplete or no growth.

RESULTS:
Thirty-four patients (18 men) with a mean age of 12+/-3years were included. AA was ongoing for a mean 2 (1-17) years. Thirteen (38%) patients presented multifocal AA, six universalis (20%), six multifocal with ophiasic pattern (18%), six totalis (18%), and three ophiasic (6%).

Six patients (18%) had no regrowth. At 3months, incomplete or cosmetically acceptable response was noted in 28 patients (82%).