Interés de altas dosis de terapia con corticosteroides de pulso en combinación con metotrexato para la alopecia areata grave: una serie de casos retrospectivos.

BACKGROUND:

The combination of systemic pulse corticosteroids and methotrexate in the treatment of severe alopecia areata has never been reported.

OBJECTIVE:

The objective of this work was to give arguments for the efficacy and safety of this combined treatment.

METHODS:

This was a retrospective case series of patients treated with intravenous 500 mg methylprednisolone per day for 3 consecutive days monthly during 3 months plus methotrexate initiated at the end of the second pulse regimen. We reviewed all case notes of patients who received this regimen between January 1 2007 and December 1 2010.

RESULTS:

Twenty patients were treated. Data on hair regrowth at month 12 were available for all patients; 14 patients were still receiving the treatment on December 1 2010, 2 patients were lost of follow-up, and 4 patients had stopped the treatment. Of the 14 patients who were still receiving the treatment regimen at month 18, 10 (10/20, 50%) had total hair regrowth and 4 (4/20, 20%) had incomplete but satisfactory hair regrowth. The treatment was well tolerated.

CONCLUSION:

The initial treatment by pulse intravenous corticosteroids may influence the overall response. This approach should be evaluated in a larger series of patients.