Comparison of oral prednisolone pulse therapy with intravenous methylprednisolone pulse therapy in severe alopecia areata.

Objective To compare the efficacy of oral prednisolone pulse therapy in comparison to the intravenous methylprednisolone pulse therapy in treatment of severe alopecia areata. Patients and methods In this interventional study, all patients with alopecia areata having at least 30% involvement of scalp or more than 10 patches of alopecia in scalp and body, registered during 2006-2009 in dermatologic department of 5-Azar hospital, Gorgan, Northeast of Iran were included. Forty patients with severe alopecia areata were enrolled and divided into 2 groups. Group A was treated with 200 mg oral prednisolone in one dose, every week for 3 months and group B were treated with 500 mg intravenous methylprednisolone on 3 continuous days each month for 6 months. Results Recovery rate after 1, 3, 6 and 12th months after treatment was significantly higher in group B compared to group A. Side effects included: acne (5 in group A and 7 in group B), heartburn (4 in group A and 5 in B), striae (4 in group A and 6 in group B) and were more seen in group B but it was not significant statistically. The recovery and rate was not significantly different between two sexes. Conclusion In this study, 500 mg intravenous methylprednisolone in 3 continuous days each month for 6 months showed a better recovery rate in severe alopecia areata. Patients must be warned about the side effects and outcomes. [ABSTRACT FROM AUTHOR]