• Anh Tran Thi Van, Anh Tran Lan, Minh Ha Anh, Thuong Nguyen Van, Phuong Pham Thi Minh, Phuong Trinh Thi, Trang Trinh Minh, Nghi Dinh Huu, Tung Vu Thanh, My Le Huyen, Khang Tran Hau, Marco Gandolfi, Francesca Satolli, Claudio Feliciani, Michael Tirant, Aleksandra Vojvodic, and Torello Lotti.
• National Hospital of Dermatology and Venereology, Hanoi, Vietnam.
• Open Access Maced J Med Sci. 2019 Jan 30; 7 (2): 200-203.

BackgroundTreatment of severe alopecia areata remains very difficult, especially in alopecia areata totalis and alopecia areata universalis. Methotrexate is known to be effective in the treatment of severe and chronic autoimmune disorders.ObjectiveTo assess the effectiveness and safety of MTX in combination with mini pulse dose of methylprednisolone in the treatment of severe alopecia areata.Patients And MethodsThe open, uncontrolled study compared pre-treatment and after-treatment. Thirty-eight patients (age 16-64) with severity AA (SALT score > 50 %) visiting National hospital of Dermatology and Venereology from April-2004 to September-2015 were enrolled. All patients received oral methylprednisolone 24mg/day for 3 consecutive days of a week in combination with oral MTX 7,5 mg weekly. This regimen is maintained up to 12 weeks and follow-up until to 6 months.ResultsAfter 6 months, 60.5% of patients show complete hair growth (good response) and 18.4% shows the medium response. There is a significant SALT score reduction: mean baseline SALT score 84.39 ± 17.03 compared to mean post-treatment SALT score 24.19 ± 29.42. Good clinical improvement noted in after 3 months. We do not observe any side- effects related to oral MTX and oral methylprednisolone, and no patients had to withdrawal treatment due to side- effects.ConclusionCombination Methotrexate and mini pulse dose of methylprednisolone are effective and safe in treatment severity alopecia areata.

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