皮质类固醇激素治疗顽固性斑秃的疗效评价

目的　评价得宝松皮损内注射及甲基强的松龙静脉内冲击治疗顽固性多灶性斑秃的疗效。方法　对 2 3例病程在 13个月至 6年的斑秃患者 ,于皮损内注射得宝松 (0 .1ml/cm2 ) ,治疗结束 2个月后判定疗效 ,对得宝松治疗无效的病例 ,予甲基强的松龙冲击治疗 ,5 0 0mg/日 ,每月静滴 3天 ,连续治疗 3个月。结果　得宝松治疗组痊愈及显效病例为 11例 (4 7.83 % ) ,甲基强的松龙组痊愈及显效病例为 4例 (5 7.14% )。结论　皮损内注射得宝松及甲基强的松龙静脉内冲击治疗对病程至少是 13个月的顽固性多灶性斑秃患者 ,有较好的疗效 ,对其他治疗手段抵抗的病例 ,只要掌握好适应证 ,皮质类固醇激素冲击治疗也是一种有效的治疗方法

Steroid topical therapy and pulse dosing therapy for multifocal alopecia areata

Objective To evaluate the efficacy of intralesional Diprospan(compound betamethasone) injection therapy and high dose steroid pulse therapy with methylprednisolone in patients with multifocal alopecia areata lasting more than 13 months. Methods Twenty-third patients with localized multifocal alopecia areata of scalp lasting from 13 months to 6 years were treated with Diprospan topical intralesional injection therapy( given at 0.1?ml/cm 2). We tried intravenous high-dose corticosteroid therapy with methylprednisolone in seven cases unyielding to Diprospan intralesional therapy, given at 500?mg per day,three times monthly for 3 months. Results After two months of topical diprospan 11 cases had 50% or more improvement and less than 50% hair regrowth in 3 cases and no or poor regrowth of hair in 9 cases. With methylprednisolone pulse dosing therapy, 4 of the 7 cases had improved with regrowth of hair over 50% after three months. Conclusion Our results indicated that topical intralesional therapy with diprospan and intravenous methylprednisolone pulse dosing therapy are effective and well tolerated in longstanding and multifocal alopecia areata. We consider intravenous high-dose corticosteroids as an alternative therapy in severe alopecia areata anyielding to other treatment.