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.