Seven children with severe, rapidly evolving alopecia areata (AA) were
treated with pulse steroid therapy (PST). AA had been present for 3-4
4 weeks and involved more than 30% of the scalp. One patient had alope
cia totalis. Intravenous methylprednisolone (5 mg/kg twice a day) was
administered for 3 days. No serious side effects were noted. At the 12
-month follow-up, complete regrowth had occurred in 5 patients (71%).
The patient with alopecia totalis had no regrowth. PST appears to be a
promising and safe treatment for extensive, recent-onset AA in childr
en. No response is to be expected in alopecia totalis or long-standing
AA.