A Clinical Study of Alopecia Areata (1996-2000)

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Authors:
YJ Kim, YS Chong, BI Ro.
Dept. of Dermatology, College of Medicine, Chung Ang University, Seoul, Korea

Study Information and Results:

To evaluate the clinical manifestations and the effects of treatment we performed clinical study of 532 patients with alopecia areata (including Alopecia Totalis: 28 cases, Alopecia Universalis : 41 cases) who had visited the Dept. of Dermatology, College of Medicine, Chung Ang University during the 4 years from March, 1996 to February, 2000.

Results were as follows:

1) There was 290 male and 242 female patients being most prevalent in the third decade (32.5%) and the average was 26.8 years and 96 cases(18.0%) showed alopecia areata in children.
2) The most common site of predilection was the occipital region in both male and female, which were 167 cases (57.6%), 89 cases (36.8%) respectively.
3) Previous episodes of alopecia areata were observed in 153 cases (28.8%), and family history was observed in 48 cases (9.0%).
4) Associated diseases with alopecia areata were seborrheic dermatitis (174 cases), atopic dermatitis(16 cases), hepatitis (11 cases) urticaria (10 cases), diabetes mellitus (8 cases), etc in 301 cases (56.6%).
5) The effect of treatment modalities (DPCP, intralesional triamcinolone injection, and PUVA) revealed no difference based on increases in the size and number of bald areas.

Based on our findings, alopecia areata prominently developed in the third decade, and alopecia areata in children, previous history and severity of alopecia areata were increased. Therapeutic modalities on alopecia areata revealed no difference.

Successful Treatment of Alopecia Totalis Universalis by General PUVA Therapy Combined with Systemic and Topical Corticosteroids

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Authors:
M Yamashita, R Tsuboi, K Takamori

Study Information and Results:

Alopecia totalis and universalis patients 15 years old or older, who visited Juntendo University Hospital from 1994 to 1998, were enrolled in this study.

Alopecia Totalis patients (108 cases) and Alopecia Universalis patients (175 cases) were treated with one of four different regimens for more than six months, and the rate of efficacy, recurrence and adverse effects of each modality were compared.

Group 1 (N=58) was treated with topical immunotherapy using SADBE; group 2 (N=85), with topical corticosteroids; group 3 (N=104), with systemic and topical corticosteroids; group 4 (N=36), with oral 8-methoxypsoralen and general UVA irradiation combined with systemic and topical corticosteroids. The therapeutic effects were quantitatively compared by scoring the degree of hair regrowth.

The results indicated the following percentage figures for moderate and marked improvement in each group: group 1, 41.4% (15.5%); group 2, 37.6% (23.5%); group 3, 57.7% (43.3%); group 4, 72.2% (61.1%). Meanwhile, the recurrence rate was 66.6% for group 1, 30.0% for group 2, 35.6% for group 3 and 13.6% for group 4.

The efficacy rate of groups 3 and 4 was superior to that of groups 1 and 2.

Group 1 showed a low rate of marked improvement and a high recurrence rate, while group 4 showed a high rate of marked improvement and a low recurrence rate. Adverse effects caused by the application of topical and systemic corticosteroids were frequently observed in groups 2 to 4, but were improved after tapering the dose of corticosteroids.

Among the four treatments tested, general PUVA therapy, combined with systemic and topical corticosteroids, is the best treatment both in terms of efficacy and recurrence rate, and is recommended as an excellent treatment for adult alopecia totalis and universalis.