Long-Term Outcomes of Intravenous Corticosteroid Pulse Therapy for Rapidly Progressive Alopecia Areata: A Single-Center Retrospective Analysis of 106 Cases and Evaluation of a Scoring System for Extended Periods

This study retrospectively analyzed 106 patients with rapidly progressive alopecia areata (RP-AA) treated with intravenous corticosteroid pulse therapy (IVPT) over a period of up to 6.8 years. The results showed that 74.5% of patients achieved a good response (SALT score ≤25) by the final evaluation, with 16 patients maintaining full hair regrowth with IVPT alone. A scoring system originally designed for short-term efficacy prediction was effective in distinguishing long-term responders from poor responders. Additionally, the study identified that the absence of preceding infectious diseases was a significant factor in predicting relapse, leading to a revised scoring system that successfully predicted relapse occurrence. This research highlights the real-world efficacy of IVPT for RP-AA and introduces a tool for optimal long-term management.