Efficacy and Predictive Factors of Systemic Corticosteroid in Alopecia Areata: Reappraisal of Oral Methylprednisolone Tapering Treatment

This study evaluated the efficacy and predictive factors of an eight-week tapering methylprednisolone treatment (ETMT) in 136 alopecia areata (AA) patients. Results showed that 75% of patients responded well to the treatment, with a 50% improvement from baseline severity. Poor prognostic factors for treatment response included young age (<15 years) and extensive alopecia affecting 50% or more of the scalp. Nail involvement was initially considered a poor prognostic factor but lost significance in multivariate analysis. Common adverse events included acne (14.7%), gastrointestinal issues, moon face, and weight gain. Among good responders, 28.4% experienced relapse approximately 5.48 months after stopping ETMT, with low vitamin D levels being a significant predictor of relapse. The study suggests that young age and extensive alopecia are associated with poor response to ETMT, and vitamin D levels may help predict relapse.