Corticosteroids in the treatment of alopecia totalis. Systemic effects

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Abstract
Patients (15) with alopecia totalis (AT) or alopecia universalis (AU) were treated with combined topical, intralesional and oral corticosteroids. All or virtually all scalp hair regrew on 7 patients, and they were able to discontinue oral corticosteroids without recurrence of AT or AU for periods of 3 mo. to 7 1/2 yr, with an average remission of 32 mo. Additional patients (2) are currently receiving 5 mg of prednisone every 2 days. Using topical and intralesional corticosteroids in more resistant areas allowed for more rapid lowering of oral doses and thus side effects were minimized. In view of the usually nearly hopeless prognosis for AT and AU and the results reported here, a trial course of topical, intralesional and oral corticosteroid treatment would seem to be reasonable for highly motivated patients.

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