Aggressive Steroid Therapy for Treatment of Alopecia Areata

Q:

My daughter, aged 20, has recently become the victim of AU.  I am a doctor myself and understand the etiology.I would like to know if there are any reports on therapy using IV methylprednisolone and endoxon.

I would also like to know if there is any relation of AU WITH ERYTHROCYTOPENIA as my daughter is having Hb around 9-10% RBC COUNT OF 3.3 to 3.6 million.

A:

Yes, several studies have concluded which indicate use of high dose steroids as pulse therapy to improve the outcome of Alopecia Areata (AA) and its more severe forms Alopecia Universalis (AU) if used early on in the process of the disease.

The results of a study  performed on 66 people who suffered from severe alopecia areata were published in 2003 to show a positive response in patients; with Alopecia Universalis results were favorable in about 80% of patients.  There has been a high rate of relapse among the treated patients of the study, but a few have stayed clear of the disease following their first treatment. More information on this study can be found here: http://www.ncbi.nlm.nih.gov/pubmed/12746668

This study provides the best indication of pulse methylprednisolone therapy: first recent episode of extensive plurifocal alopecia areata. These results are less convincing in patients with a long term history of the disease or other advanced forms of alopecia areata.

There have been strong links to support autoimmune etiology for Alopecia Areata and its more severe form of Alopecia Universalis.  The disease has also been seen in other diseases that are autoimmune in nature.  It is not clear, however, why alopecia areata and other autoimmune diseases might be present concurrently in the same person.

There are some suggestions regarding the possible triggers for autoimmune attacks (i.e.- viruses, infection, medicines, sunlight, or other environmental factors) that can prompt the immune system in a extraordinary method to attack the body’s own tissues. Pernicious anemia, a serious form of anemia, is typically caused by autoimmune processes and has often been present in patients with Alopecia Areata or Alopecia Universalis.

I believe a thorough evaluation of your daughter for the causes of her erythrocytopecia is the first priority at this point.  Your daughter may have a systemic condition that aggravated both her skin and hematologic conditions which should be investigated by a qualified dermotologist in your area.

To see more information on hair loss caused by autoimmune and other diseases, please visit our Other Types of Hair Loss page.