Prognostic Factors in Methylprednisolone Pulse Therapy for Alopecia Areata

This study evaluated the prognostic factors for methylprednisolone pulse therapy in 70 patients with severe alopecia areata, characterized by rapid and extensive hair loss exceeding 50% of the scalp. The treatment involved high-dose bolus infusions of methylprednisolone over 3 consecutive days. Results showed that 70% of patients experienced terminal hair growth, and 41.4% had complete responses with acceptable cosmetic outcomes. Key prognostic factors for a successful outcome included the disease duration before treatment and the type of alopecia areata. Patients with a disease duration of 3 months or less, and those with the plurifocal type of alopecia areata with a duration of 4-6 months, showed the best responses. Thus, methylprednisolone pulse therapy was indicated for patients fitting these criteria.