Interest of High-Dose Pulse Corticosteroid Therapy Combined with Methotrexate for Severe Alopecia Areata: A Retrospective Case Series

The retrospective case series study evaluated the efficacy and safety of a combined treatment of high-dose pulse corticosteroids and methotrexate for severe alopecia areata. The treatment involved administering 500 mg of intravenous methylprednisolone per day for 3 consecutive days each month over 3 months, with methotrexate initiated after the second pulse regimen. The study included 20 patients treated between January 1, 2007, and December 1, 2010. At the 12-month mark, data were available for all patients: 10 patients (50%) achieved total hair regrowth, and 4 patients (20%) experienced incomplete but satisfactory hair regrowth. The treatment was well tolerated. The study concluded that the initial treatment with pulse intravenous corticosteroids may influence the overall positive response and suggested that this approach should be evaluated in a larger patient series.