Early Intervention with High-Dose Steroid Pulse Therapy Prolongs Disease-Free Interval of Severe Alopecia Areata: A Retrospective Study

This retrospective study investigated the effects and safety of high-dose steroid pulse therapy, both oral and intravenous, on severe alopecia areata (AA) in 85 patients treated between 1999 and 2010. The overall satisfactory response rate was 51.8%, with a mean follow-up time of 37.6 months and a relapse rate of 22.7%. Patients with AA of recent onset (within one year) had significantly higher response rates (p<0.001) and lower relapse rates compared to those with AA persisting for more than one year. Early treatment also showed a 47% satisfactory response rate in severe cases like alopecia totalis, alopecia universalis, or ophiasis type. The study concluded that oral steroid pulse therapy was as effective and well-tolerated as intravenous therapy, suggesting it as the first-line treatment for severe AA of recent onset.