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.