Treatment of extensive alopecia areata with oral prednisolone mini-pulse regimen

Background Systemic steroids in mini doses have been reported effective in the treatment of alopecia areata. Objective To evaluate the efficacy of oral prednisolone in mini pulse regimen in the treatment of severe forms of alopecia areata. Patients and methods This open uncontrolled study was conducted at the Department of Dermatology and Medicine,LiaquatUniversityHospital,Hyderabad from June, 2007 to July, 2008. All adult patients of both genders not receiving any topical or systemic treatment were enrolled in study. Non-probability convenience technique was used for sampling. After recording personal data and short history regarding the onset, duration and treatment received; thorough cutaneous and systemic examination was done. The patients were assessed clinically and with photographs at all visits. All patients received 30 mg oral prednisolone for 3 consecutive days in a week for 6 months. They were assessed for response and side effects at monthly intervals. The post treatment follow-up was done for 6 months. The findings were recorded on close ended proforma. The data were analyzed using SPSS software version 11.0. Results Fourteen male and 8 female patients aged between 16 and 40 years (mean 25.5 years) were enrolled for study. The duration of the disease at the time of presentation was from 6 months to 10 years (mean 3.6 years). Fourteen patients had extensive alopecia of scalp, 6 alopecia totalis while 2 alopecia universalis. Eight (15.7%) patients showed excellent response and 5 (9.8%) good response. The response was satisfactory in 7 (13.7%) and unsatisfactory in 2 (3.9%) patients. Conclusion Low dose steroids in mini-pulse regimen are an effective treatment modality for treating AA.