Combination Therapy With Oral PUVA and Corticosteroid for Recalcitrant Alopecia Areata

    Taisuke Ito, Masahiro Aoshima, Natsuho Ito, Izumi Uchiyama, Keiko Sakamoto, Tetsuya Kawamura, Hiroaki Yanagimoto, Hideo Hashizume, Masaharu Takigawa
    TLDR The combination of oral PUVA and corticosteroids helps regrow hair in severe alopecia areata.
    The study investigated the effectiveness of a combination therapy using oral corticosteroids and oral PUVA for treating severe alopecia areata (AA), specifically alopecia totalis (AT) and alopecia universalis (AU). Patients received 20 mg/day of corticosteroids and whole-body UVA irradiation 2 hours after taking methoxsalen for 1 month. All patients experienced regrowth of terminal hair on the scalp within 2 months, although two patients relapsed 3 months post-treatment. The therapy increased the population of regulatory T cells (Tregs) and decreased the number of infiltrating cells in the skin lesions, suggesting an immune-modulating effect that contributed to the improvement of recalcitrant AA.
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