Senila Simona C, Danescu Sorina A, Ungureanu Loredana, Candrea Elisabeta, Cosgarea Rodica M
Department of Dermatology, University of Medicine and Pharmacy "I. Hatieganu", Cluj Napoca, Romania, Romania.
Indian J Dermatol Venereol Leprol. 2015 Jan-Feb;81(1):95. doi: 10.4103/0378-6323.148608.
Severe, extensive, therapy resistant alopecia areata represents a clinical challenge. Systemic corticosteroids are a therapeutic tool that still needs to be evaluated.
The purpose of this study was to assess the efficacy and safety of methylprednisolone pulse therapy in alopecia areata and to find prognostic factors for a favourable outcome.
A total of 32 patients with severe multifocal alopecia areata (more than 40% scalp hair loss), alopecia totalis, and alopecia universalis were treated with infusions of 500 mg methylprednisolone for 3 days every month for 3 consecutive months. The end point of the study was 12 months.
Of 32 patients, 26 (81.3%) reported a clinical response. Four patients (12.5%) showed complete hair regrowth, 6 patients (18.8%) showed >50% hair regrowth, ten (31.3%) had <50% hair regrowth, 6 (18.75%) were non responders, and another 6 patients (18.8%) had relapse after an initial regrowth. Multivariate analysis revealed that patients reporting at the first episode and those with multifocal disease had the best results.
Methylprednisolone infusions represent a possible therapeutic option for patients with multifocal alopecia areata and those presenting with the first episode of the disease.
严重、广泛、治疗抵抗性斑秃是一项临床挑战。全身用皮质类固醇是一种仍需评估的治疗手段。
本研究的目的是评估甲泼尼龙冲击疗法治疗斑秃的疗效和安全性，并找出预后良好的预测因素。
共有32例严重多灶性斑秃（头皮脱发超过40%）、全秃和普秃患者，每月连续3天输注500mg甲泼尼龙，共3个月。研究终点为12个月。
32例患者中，26例（81.3%）有临床反应。4例（12.5%）毛发完全再生，6例（18.8%）毛发再生超过50%，10例（31.3%）毛发再生不足50%，6例（18.75%）无反应，另有6例（18.8%）在最初再生后复发。多因素分析显示，首次发病的患者和多灶性疾病患者效果最佳。
甲泼尼龙输注是多灶性斑秃患者和首次发病患者的一种可能治疗选择。
