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Pulse corticosteroid therapy for alopecia areata in children: a retrospective study

Rivka Friedland1, Rotem Tal, Moshe Lapidoth

  • 1Department of Dermatology, Rabin Medical Center, Petach Tikva, Israel.

Dermatology (Basel, Switzerland)
|September 7, 2013
PubMed

Insights

Intravenous high-dose pulse corticosteroids show moderate effectiveness for pediatric alopecia areata, with relapse common. Shorter disease duration, younger age, and multifocal disease predict better outcomes.

Area of Science:

  • Pediatric Dermatology
  • Autoimmune Disorders
  • Clinical Therapeutics

Background:

  • Alopecia areata commonly affects children and adolescents.
  • Systemic steroids, particularly high-dose pulse infusions, are a frequent treatment modality.
  • Identifying predictors of treatment success is crucial for optimizing patient care.

Purpose of the Study:

  • To evaluate the efficacy and safety of intravenous high-dose pulse corticosteroids in pediatric alopecia areata.
  • To determine prognostic factors associated with successful treatment outcomes.
  • To assess the long-term relapse rates following treatment.

Main Methods:

  • A retrospective analysis of 24 children with alopecia areata treated between 2001-2008.
  • Patients received intravenous methylprednisolone (8 mg/kg) over 3 consecutive days monthly.
  • Data on treatment response, side effects, and prognostic factors were collected.

Main Results:

  • 38% achieved complete response, 29% partial response, and 33% no response after a mean of 5.65 courses.
  • 81% of responders relapsed within 9.5 months.
  • Positive prognostic factors included short disease duration (≤6 months), younger age at onset (<10 years), and multifocal disease.

Conclusions:

  • Pulse corticosteroid therapy offers a viable treatment option for pediatric alopecia areata, though relapse is frequent.
  • Careful patient selection based on prognostic factors can maximize treatment benefits.
  • Further research into long-term management strategies is warranted.
Abstract

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