Oral mega pulse methylprednisolone in alopecia universalis

Intravenous pulse corticosteroids is an alternative method of corticosteroids delivery, which proved to be safe with rapid and potent efficacy. It is an effective treatment of alopecia areata, but not for the totalis, universalis or ophiasis types, for which no effective therapy is available yet. Recently, it has been confirmed that oral and intravenous pulse methylprednisolone MP have comparable efficacy. Here, we report a 9-year-old Saudi boy with alopecia universalis who was treated with MP sodium succinate 15 mg/kg ideal body weight orally for 3 consecutive days bimonthly for 12 sessions. Complete hair regrowth was obtained without toxic effects. When the interval was increased to 4 weeks, he showed partial relapse. So, 2 more pulses were given with an interval of 3 weeks in between. This maintained his regrown hair for a year without treatment.