TherapyPlacebo-controlled oral pulse prednisolone therapy in alopecia areata
Section snippets
Patients and methods
A total of 43 consecutive patients with severe AA (≥40% loss of scalp hair or >10 patches scattered over the scalp and body) were included in the study. Patients were divided into two groups based on randomization using Tippet's random number table. Group A (n = 23) was started on weekly oral prednisolone pulse therapy (200 mg) whereas group B (n = 20) was given identical placebo tablets once weekly for 3 months. Patients were followed-up monthly for 3 months after completion of the oral pulse
Results
Of 43 patients, 7 patients (3 from group A and 4 from group B) were lost to follow-up because of reasons unrelated to the study. Comparative details of both groups are given in Table I. Significant regrowth of hair was seen in 8 (40%) patients for group A at the end of 3 months. Of these 8 patients, two had marked to complete growth of hair (Fig 1, Fig 2, Fig 3) and 6 had moderate growth. Two (25%) patients from among the 8 responders had relapse at the end of 3 months of follow-up. One of
Discussion
AA is an autoimmune disorder with an unpredictable, relapsing course. It is hypothesized to be an organ-specific autoimmune disease mediated by T lymphocytes directed at hair follicles. Although genetic predisposition and environmental factors may trigger the initiation of the disease, its exact cause is still unknown.1, 2, 3, 4, 5, 6 The cosmetic disfigurement resulting from the disease leads to marked psychologic morbidity.13 Extensive AA is difficult to treat and modalities such as topical
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2020, Anais Brasileiros de DermatologiaCitation Excerpt :Several forms of systemic administration of CTs have been described for the treatment of AA. A 200 mg oral prednisolone pulse once a week for three months presented a response rate of 40% in patients with more than 40% of the affected scalp or more than ten patches on the scalp or body.39 Other regimens include prednisolone 80 mg/day for three consecutive days every three months and for patients resistant to other therapeutic modalities, a megapulse of 15 mg/kg for two days every three weeks.40,41
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Conflicts of interest: None identified.