In an attempt to stop the evolution of recent-onset severe alopecia ar
eata (AA), we tested pulse corticotherapy on 9 patients. Acceptance in
to the study was based on the following criteria: recent-onset AA (< 1
year), AA in an active state, bald surface > 30% of the scalp, no con
traindication to pulse corticotherapy. Each patient was given 250 mg i
.v. of methylprednisolone twice a day on 3 successive days. In 8 patie
nts the course of the ongoing episode of AA was stopped. At the 6-mont
h follow-up, a regrowth on 80-100% of the bald surface was observed in
6 patients. One patient did not respond to treatment, and 2 had less
than 50% of regrowth. This open study suggests that pulse corticothera
py: (1) can stop the course of severe AA in an active state, (2) is we
ll tolerated without major side effects and (3) does not permit a stab
le control of AA of more than 1 year duration. This treatment seems to
be indicated for severe AA of recent onset.