Successful Therapy of Alopecia Universalis Using a Combination of Systemic Methotrexate and Corticosteroids and Topical 5% Minoxidil

• Main Authors: Ruchiatan K (Author), Avriyanti E (Author), Hindritiani R (Author), Puspitosari D (Author), Suwarsa O (Author), Gunawan H (Author)
• Format: Book
• Published: Dove Medical Press, 2022-01-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.

Summary

Kartika Ruchiatan, Erda Avriyanti, Reti Hindritiani, Diah Puspitosari, Oki Suwarsa, Hendra Gunawan Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran - Dr. Hasan Sadikin General Hospital, Bandung, West Java, IndonesiaCorrespondence: Kartika RuchiatanDepartment of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran - Dr. Hasan Sadikin General Hospital, Pasteur 38, Bandung, West Java, 40161, Indonesia, Tel [phone] ext. 3449; [phone], Email [e-mail]: Alopecia areata (AA) is an autoimmune disease-specific to specific organs mediated by T lymphocytes with hair follicles as targets. Severe AA could be in the form of alopecia universalis (AU). AU therapy is relatively difficult and challenging with varying outcomes. Herein, we reported a case of AU in a 19-year-old man with alopecia in the hairy scalp area, eyebrows, eyelashes, moustache, beard, and axillary hair since 2.5 years ago. The patient's severity of alopecia tool (SALT) score was 100%. The patient was given a combination therapy of 15 mg methotrexate per week and 16 mg methylprednisolone per day orally and topical treatment with minoxidil 5%. Observations after nine months of treatment showed an improvement in the decrease in SALT scores to 41%. However, striae were found after 3rd month of therapy. Systemic combination therapy of methotrexate and low-dose corticosteroids and topical minoxidil 5% in this patient gave responsive results. Performed the hematological examination, liver function levels, blood glucose levels, and cortisol during long-term use of methotrexate and corticosteroids are necessary. The combination of systemic methotrexate and corticosteroids, and topical minoxidil showed promising results in AU. Nevertheless, long-term observation is still needed to monitor the side effects of therapy.Keywords: alopecia areata, alopecia universalis, corticosteroid, methotrexate, minoxidil

Item Description

1178-7015