Una revisión sistemática de la terapia con esteroides pulso para la alopecia areata

Alopecia areata (AA) is an autoimmune disease that causes emotional and social distress. Proper assessment of the efficacy of different therapies is challenging because of the disease's unpredictable nature and high rates of spontaneous remission. The most frequently used treatments are topical or intralesional corticosteroids, with systemic corticosteroids used in more severe cases.1 The use of systemic pulse corticosteroid treatment (PCT) was introduced for severe types of AA in 1975, to minimize the side effects associated with prolonged systemic corticosteroid therapy. since then, many reports on PCT have been published, whit conflict ing finfings.
To clarify this conclict, we evaluate the relevant literature with regard to the efficacy, side effects, and prognoctic factors associated with trearment response of the different regimens, including intravenous, intramuscular, or oral PCT for AA, given once monthly or once weekly. We performed a systematic review of the literature using PudMed, Cochrane, and Google Scholar databases in the English, French, and German literature between the years 1975 and 2015.
in all, 41 studies met our serch criteria (supplementary table 1: available at http://www.jadd.org), consisting of 1078 patients, but only 1 randomized controlled trial comparing PCT to placebo was found. The majority of patients had multifocal AA, and the intravenous route was the...