Combined oral pulse and topical corticosteroid therapy for severe alopecia areata in children: a long‐term follow‐up study |
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| Authors: | Jovan Lalosevic Mirjana Gajic‐Veljic Branka Bonaci‐Nikolic Milos Nikolic |
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| Affiliation: | 1. Division of Pediatric Dermatology, Clinic of DermatovenereologyClinical Center of Serbia;2. Faculty of MedicineUniversity of Belgrade;3. Clinic of Allergy and Clinical Immunology, Clinical Center of Serbia, Belgrade, Serbia |
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| Abstract: | There are no widely accepted therapy protocols for severe alopecia areata (AA). We treated 65 children/adolescents with AA affecting >30% of scalp. Fourty‐three percent of patients had AA plurifocalis (AAP). Fifty‐seven percent had AA subtotalis (AAS), AAP+ophiasis (AAP+OPH), and alopecia totalis/universalis (AT/AU). Long‐term follow‐up (median 96 months) data were available for 69% of patients. Oral dexamethasone (prednisolone 5 mg/kg equivalent) was given once in 4 weeks. Patients received 6, 9, or 12 pulses. Clobetasol propionate 0.05% ointment under plastic wrap occlusion was applied 6 days a week. Hair growth was assessed on a scale ranging 0–100% of regrowth in individual AA lesions. Regrowth >50% was considered good response. Six to twelve months months after the therapy, 56.9% of patients had >75% of hair regrowth. In AAP, 65.5% had complete regrowth. 61.5% of all patients were considered good responders. Significantly, higher percentage of good responders was found in AA lasting ≤12 months. No patients had serious side effects. There was no change in stability of the hair status at the long‐term follow‐up. Most AA patients had beneficial effects with this protocol. Best results were in AAP and AAP+OPH. Combined topical and oral pulse corticosteroid therapy of AA in children shows long‐lasting results, without serious side effects. |
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| Keywords: | alopecia therapy clobetasol pulse corticosteroids |
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