Recalcitrant widespread alopecia areata in a child treated successfully with oral methylprednisolone pulse therapy

Neerja Puri

doi:10.7241/ourd.20133.76

Abstract

Alopecia areata is a common condition with patchy non scarring hair loss. We report a case of an 11 year old male child with localized patch of hair loss on the frontoparietal region of the scalp since one year. It was a widespread extensive patch of hair loss covering more than 40% of the scalp. On hair shaft microscopy, numerous exclamation mark hairs were present. The patient was put on topical tacrolimus and topical corticosteroids but no response was seen. Since the child was recalcitrant to treatment, methylprednisolone 500 mg/day on three consecutive days in a month was given. After six months 80% regrowth was seen over the affected area of the scalp.

Highlights

Alopecia areata (AA) is a relatively common patchy nonscarring hair loss condition
Pulse corticosteroid therapy has been used to control the active phase of hair loss of AA
According to the recent reports, the dosage of pulse corticosteroids commonly used in treating AA is 500 mg/day or 8 mg/kg/day of intravenous methylprednisolone for 3 consecutive days [6,7]

Summary

Introduction

Alopecia areata (AA) is a relatively common patchy nonscarring hair loss condition. The annual incidence rate is 20. 2 per 100,000 and the lifetime risk is estimated at 1.7% [1]. Pulse corticosteroid therapy has been used to control the active phase of hair loss of AA. Acute phases of hair loss are followed by spontaneous hair regrowth in most patients, the disorder may persist for many years or even for life when severe. Even in these cases hair loss is potentially reversible, because the disease usually does not result in destruction of hair follicles or scarring. Case Report An 11 year old male child reported to the department of dermatology with localized patch of hair loss on the frontoparietal region of the scalp since one year. After six months 80% regrowth was seen over the affected area of the scalp

Findings

Discussion

Conclusion