Chronological Clinicopathological Characterization of Rapidly Progressive Alopecia Areata Resistant to Multiple Intravenous Corticosteroid Pulse Therapies: An Implication for Improving Efficacy

July 2018 in “ The Journal of Dermatology ”

Masataka Fukuyama, Yohei Sato, Misaki Kinoshita‐Ise, Y. Yamazaki, Manabu Ohyama

alopecia areata rapidly progressive alopecia areata intravenous corticosteroid pulse therapy methylprednisolone perifollicular lymphocytic inflammation RP-AA IV corticosteroid pulse therapy

TLDR Current corticosteroid pulse therapy is not very effective for severe rapidly progressive alopecia areata.

The study conducted a retrospective clinicopathological analysis on eight cases of rapidly progressive alopecia areata (RP-AA) resistant to initial intravenous corticosteroid pulse therapy. Despite additional rounds of pulse therapy, only three cases showed partial hair regrowth, and all experienced relapse over time. Histopathological analysis revealed persistent, dense perifollicular lymphocytic inflammation, which was more severe compared to good responders of pulse therapy. The findings suggested that repetitive pulse therapy had limited efficacy in severe RP-AA cases, indicating a need for dose modulation, interval adjustment, and alternative treatment approaches to improve outcomes.

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