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. Copyright (c) 2012 S. Karger AG, Basel
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Sunnybrook Hlth Sci Ctr, Dept Med, Div Dermatol, Toronto, ON, Canada
Univ Toronto, Dept Med, Toronto, ON, Canada
Kyorin Univ, Fac Med, Dept Dermatol, Tokyo, JapanSunnybrook Hlth Sci Ctr, Dept Med, Div Dermatol, Toronto, ON, Canada
Kinoshita-Ise, Misaki
Sachdeva, Muskaan
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Univ Toronto, Dept Med, Toronto, ON, CanadaSunnybrook Hlth Sci Ctr, Dept Med, Div Dermatol, Toronto, ON, Canada
Sachdeva, Muskaan
Martinez-Cabriales, Sylvia A.
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Sunnybrook Hlth Sci Ctr, Dept Med, Div Dermatol, Toronto, ON, Canada
Univ Toronto, Dept Med, Toronto, ON, Canada
Autonomous Univ Nuevo Leon, Sch Med, San Nicolas De Los Garza, NL, MexicoSunnybrook Hlth Sci Ctr, Dept Med, Div Dermatol, Toronto, ON, Canada
Martinez-Cabriales, Sylvia A.
Shear, Neil H.
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Sunnybrook Hlth Sci Ctr, Dept Med, Div Dermatol, Toronto, ON, Canada
Univ Toronto, Dept Med, Toronto, ON, CanadaSunnybrook Hlth Sci Ctr, Dept Med, Div Dermatol, Toronto, ON, Canada
Shear, Neil H.
Lansang, Perla
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Sunnybrook Hlth Sci Ctr, Dept Med, Div Dermatol, Toronto, ON, Canada
Univ Toronto, Dept Med, Toronto, ON, Canada
Hosp Sick Children, Dept Paediat Med, Sect Paediat Dermatol, Toronto, ON, CanadaSunnybrook Hlth Sci Ctr, Dept Med, Div Dermatol, Toronto, ON, Canada
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Tulane Univ, Dept Dermatol, New Orleans, LA USATulane Univ, Dept Dermatol, New Orleans, LA USA
Gallaga, Natalya M.
Carrillo, Brenda
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Univ Texas Med Branch, Sch Med, Galveston, TX USA
Univ Texas Med Branch, Dept Dermatol, 301 Univ Blvd, Galveston, TX 77550 USATulane Univ, Dept Dermatol, New Orleans, LA USA
Carrillo, Brenda
Good, Allison
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Univ Texas Med Branch, Dept Dermatol, Galveston, TX USATulane Univ, Dept Dermatol, New Orleans, LA USA
Good, Allison
Munoz-Gonzalez, Ayezel
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Univ Texas Med Branch, Dept Dermatol, Galveston, TX USATulane Univ, Dept Dermatol, New Orleans, LA USA
Munoz-Gonzalez, Ayezel
Ross, Lindy
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Univ Texas Med Branch, Dept Dermatol, Galveston, TX USATulane Univ, Dept Dermatol, New Orleans, LA USA