Pulse steroid therapy for children's severe alopecia areata?

Seven children with severe, rapidly evolving alopecia areata (AA) were treated with pulse steroid therapy (PST). AA had been present for 3-44 weeks and involved more than 30% of the scalp. One patient had alopecia totalis. Intravenous methylprednisolone (5 mg/kg twice a day) was administered for 3 days. No serious side effects were noted. At the 12-month follow-up, complete regrowth had occurred in 5 patients (71%). The patient with alopecia totalis had no regrowth. PST appears to be a promising and safe treatment for extensive, recent-onset AA in children. No response is to be expected in alopecia totalis or long-standing AA.