Comparison of High-Dose Corticosteroid Pulse Therapy and Combination Therapy Using Oral Cyclosporine with Low-Dose Corticosteroid in Severe Alopecia Areata

The study compared high-dose corticosteroid pulse therapy with combination therapy using oral cyclosporine and low-dose corticosteroid in 142 patients with severe alopecia areata (AA). It found that corticosteroid pulse therapy was more effective, particularly for patients with the plurifocal (PF) type and those treated within 3 months of disease onset, with 64.6% showing good responses (>50% hair regrowth). In contrast, 50% of patients on combination therapy showed good responses, with no significant impact from AA type or disease duration. Both treatments had similar relapse rates and adverse effects, but corticosteroid pulse therapy was suggested as a better option for PF type AA.