Alopecia Universalis Treated with Simvastatin/Ezetimibe, Minoxidil, and Prednisolone in a 6-Year-Old Girl

In 2019, a 6-year-old girl with alopecia universalis (AU) was treated with a combination of simvastatin/ezetimibe, minoxidil, and prednisolone after previous treatments failed to yield results. Initially, simvastatin and minoxidil were prescribed, but after no improvement, the regimen was changed to include simvastatin/ezetimibe and an increased dose of minoxidil, with pulsed prednisolone added later. This treatment led to hair regrowth after 2 months, and after 1 year, the girl had 90% scalp coverage. However, she experienced mild liver enzyme abnormalities, which worsened over time, leading to a reduction in simvastatin dosage. After 3 years of treatment, near-complete remission was maintained with a maintenance regimen, and a residual area of alopecia was treated with triamcinolone injections. This case is notable as it is the first reported successful treatment of AU in a child with this combination of drugs.