A Systematic Review of Pulse Steroid Therapy for Alopecia Areata

The systematic review evaluated pulse corticosteroid therapy (PCT) for alopecia areata (AA) across 41 studies with 1,078 patients, finding a 40% response rate in the only randomized controlled trial and a complete response in 43% of the total population, with 51% in pediatric studies. The relapse rate was 17% overall but 60% in pediatric cases. Side effects were reported in 21% of patients and were generally minor. Good prognostic factors included short disease duration, multifocal AA, and first episode of disease. The review emphasized the need for standardized clinical protocols and more well-controlled trials to optimize therapy.