Journal Mobile Options
Table of Contents
Vol. 215, No. 4, 2007
Issue release date: October 2007

Pulse Corticosteroid Therapy for Alopecia Areata: Study of 139 Patients

Nakajima T. · Inui S. · Itami S.
To view the fulltext, log in and/or choose pay-per-view option

Individual Users: Register with Karger Login Information

Please create your User ID & Password





Contact Information











I have read the Karger Terms and Conditions and agree.

To view the fulltext, please log in

To view the pdf, please log in

Abstract

Background/Aim: Recent reports of pulse corticosteroid therapy for alopecia areata (AA) show its efficacy for patients with a history of ≤1 year but not for recalcitrant cases or alopecia totalis/universalis. The purpose of this study was to evaluate the efficacy and safety of pulse corticosteroid therapy for recent-onset AA patients. Method: A total of 139 severe AA patients aged >15 years were included in this study. The duration from the onset of active hair loss was within 12 months for 125 (89.9%) of those patients. Results: Of the patients, 72.7% had hair loss on >50% of their scalp area. Among the recent-onset group (duration of AA ≤6 months), 59.4% were good responders (>75% regrowth of alopecia lesions), while 15.8% with >6 months duration showed a good response. Recent-onset AA patients with less severe disease (≤50% hair loss) responded at a rate of 88.0%, but only 21.4% of recent-onset patients with 100% hair loss responded. No serious adverse effects were observed.



Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

References

  1. Safavi KH, Muller SA, Suman VJ, Moshell AN, Melton LJ 3rd: Incidence of alopecia areata in Olmsted County, Minnesota, 1975 through 1989. Mayo Clin Proc 1995;70:628–633.
  2. Tosti A, De Padova MP, Minghetti G, Veronesi S: Therapies versus placebo in the treatment of patchy alopecia areata. J Am Acad Dermatol 1986;15:209–210.
  3. MacDonald Hull SP, Wood ML, Hutchinson PE, Sladden M, Messenger AG: Guidelines for the management of alopecia areata. Br J Dermatol 2003;149:692–699.
  4. Gilhar A, Kam Y, Assy B, Kalish RS: Alopecia areata induced in C3H/HeJ mice by interferon-gamma: evidence for loss of immune privilege. J Invest Dermatol 2005;124:288–289.
  5. Dillaha CJ, Rothman S: Therapeutic experiments in alopecia areata with orally administered cortisone. J Am Med Assoc 1952;150:546–550.
  6. Burton JL, Shuster S: Large doses of glucocorticoid in the treatment of alopecia areata. Acta Derm Venereol 1975;55:493–496.
  7. Kurosawa M, Nakagawa S, Mizuashi M, Sasaki Y, Kawamura M, Saito M, Aiba S: A comparison of the efficacy, relapse rate and side effects among three modalities of systemic corticosteroid therapy for alopecia areata. Dermatology 2006;212:361–365.
  8. Perriard-Wolfensberger J, Pasche-Koo F, Mainetti C, Labarthe MP, Salomon D, Saurat JH: Pulse of methylprednisolone in alopecia areata. Dermatology 1993;187:282–285.
  9. Sharma VK: Pulsed administration of corticosteroids in the treatment of alopecia areata. Int J Dermatol 1996;35:133–136.
  10. Friedli A, Labarthe MP, Engelhardt E, Feldmann R, Salomon D, Saurat JH: Pulse methylprednisolone therapy for severe alopecia areata: an open prospective study of 45 patients. J Am Acad Dermatol 1998;39:597–602.
  11. Seiter S, Ugurel S, Tilgen W, Reinhold U: High-dose pulse corticosteroid therapy in the treatment of severe alopecia areata. Dermatology 2001;202:230–234.
  12. Assouly P, Reygagne P, Jouanique C, Matard B, Marechal E, Reynert P, Bachelez H, Dubertret L: Intravenous pulse methylprednisolone therapy for severe alopecia areata: an open study of 66 patients (in French). Ann Dermatol Venereol 2003;130:326–330.
  13. Kar BR, Handa S, Dogra S, Kumar B: Placebo-controlled oral pulse prednisolone therapy in alopecia areata. J Am Acad Dermatol 2005;52:287–290.
  14. Olsen EA, Hordinsky MK, Price VH, Roberts JL, Shapiro J, Canfield D, Duvic M, King LE Jr, McMichael AJ, Randall VA, Turner ML, Sperling L, Whiting DA, Norris D: Alopecia areata investigational assessment guidelines – Part II. National Alopecia Areata Foundation. J Am Acad Dermatol 2004;51:440–447.
  15. Olsen E, Hordinsky M, McDonald-Hull S, Price V, Roberts J, Shapiro J, Stenn K: Alopecia areata investigational assessment guidelines. National Alopecia Areata Foundation. J Am Acad Dermatol 1999;40:242–246.
  16. Rook A, Dawber R: Diseases of the Hair and Scalp. Oxford, Blackwell Scientific Publications, 1982.
  17. Seyrafi H, Akhiani M, Abbasi H, Mirpour S, Gholamrezanezhad A: Evaluation of the profile of alopecia areata and the prevalence of thyroid function test abnormalities and serum autoantibodies in Iranian patients. BMC Dermatol 2005;5:11.
  18. Shellow WV, Edwards JE, Koo JY: Profile of alopecia areata: a questionnaire analysis of patient and family. Int J Dermatol 1992;31:186–189.
  19. Goh C, Finkel M, Christos PJ, Sinha AA: Profile of 513 patients with alopecia areata: associations of disease subtypes with atopy, autoimmune disease and positive family history. J Eur Acad Dermatol Venereol 2006;20:1055–1060.
  20. Lewinski A, Broniarczyk-Dyla G, Sewerynek E, Zerek-Melen G, Szkudlinski M: Abnormalities in structure and function of the thyroid gland in patients with alopecia areata. J Am Acad Dermatol 1990;23:768–769.
  21. Messenger A: Alopecia areata; in Burns T, Breathnach S, Cox N, Griffiths C (eds): Rook’s Textbook of Dermatology. Oxford, Blackwell Publishing, 2004, vol 4, 63.36–63.46.
  22. Marques Da Costa C, Dupont E, Van der Cruys M, Andrien M, Hidajat M, Song M, Stene JJ: Earlier occurrence of severe alopecia areata in HLA-DRB1*11-positive patients. Dermatology 2006;213:12–14.
  23. Teraki Y, Imanishi K, Shiohara T: Cytokines in alopecia areata: contrasting cytokine profiles in localized form and extensive form (alopecia universalis). Acta Derm Venereol 1996;76:421–423.
  24. Zoller M, McElwee KJ, Vitacolonna M, Hoffmann R: Apoptosis resistance in peripheral blood lymphocytes of alopecia areata patients. J Autoimmun 2004;23:241–256.
  25. Christoph T, Muller-Rover S, Audring H, Tobin DJ, Hermes B, Cotsarelis G, Ruckert R, Paus R: The human hair follicle immune system: cellular composition and immune privilege. Br J Dermatol 2000;142:862–873.
  26. Paus R, Nickoloff BJ, Ito T: A ‘hairy’ privilege. Trends Immunol 2005;26:32–40.
  27. Buttgereit F, Wehling M, Burmester GR: A new hypothesis of modular glucocorticoid actions: steroid treatment of rheumatic diseases revisited. Arthritis Rheum 1998;41:761–767.
  28. Kiesch N, Stene JJ, Goens J, Vanhooteghem O, Song M: Pulse steroid therapy for children’s severe alopecia areata? Dermatology 1997;194:395–397.
  29. Sharma VK, Muralidhar S: Treatment of widespread alopecia areata in young patients with monthly oral corticosteroid pulse. Pediatr Dermatol 1998;15:313–317.
  30. Sogo T, Fujisawa T, Inui A, Komatsu H, Etani Y, Tajiri H, Waki K, Shimizu Y, Nakashima S, Imagawa T, Yokota S: Intravenous methylprednisolone pulse therapy for children with autoimmune hepatitis. Hepatol Res 2006;34:187–192.
  31. Gupta AK, Ellis CN, Cooper KD, Nickoloff BJ, Ho VC, Chan LS, Hamilton TA, Tellner DC, Griffiths CE, Voorhees JJ: Oral cyclosporine for the treatment of alopecia areata: a clinical and immunohistochemical analysis. J Am Acad Dermatol 1990;22:242–250.
  32. Shapiro J, Lui H, Tron V, Ho V: Systemic cyclosporine and low-dose prednisone in the treatment of chronic severe alopecia areata: a clinical and immunopathologic evaluation. J Am Acad Dermatol 1997;36:114–117.
  33. Phillips MA, Graves JE, Nunley JR: Alopecia areata presenting in 2 kidney-pancreas transplant recipients taking cyclosporine. J Am Acad Dermatol 2005;53:S252–S255.
  34. Moreno JC, Ocana MS, Velez A: Cyclosporin A and alopecia areata. J Eur Acad Dermatol Venereol 2002;16:417–418.
  35. Joly P: The use of methotrexate alone or in combination with low doses of oral corticosteroids in the treatment of alopecia totalis or universalis. J Am Acad Dermatol 2006;55:632–636.
  36. Heffernan MP, Hurley MY, Martin KS, Smith DI, Anadkat MJ: Alefacept for alopecia areata. Arch Dermatol 2005;141:1513–1516.
  37. Tosti A, Bellavista S, Iorizzo M: Alopecia areata: a long-term follow-up study of 191 patients. J Am Acad Dermatol 2006;55:438–441.


Pay-per-View Options
Direct payment This item at the regular price: USD 38.00
Payment from account With a Karger Pay-per-View account (down payment USD 150) you profit from a special rate for this and other single items.
This item at the discounted price: USD 26.50