Abstract:
BACKGROUND:Alopecia areata (AA) is an autoimmune skin disease difficult to manage and treat. The pathogenesis of AA features a T-cell-associated autoimmune process, and systemic immunosuppressive therapy is prescribed widely for AA. OBJECTIVE:To evaluate the efficacy and tolerance of systemic low-dose methotrexate (LD-MTX) therapy in treatment of recalcitrant AA multiplex. METHODS:In a retrospective, non-controlled study, we evaluated 29 patients with recalcitrant AA treated with LD-MTX and assessed the therapeutic response according to severity of disease, disease duration, cumulative dose of MTX, and drug safety. RESULTS:MTX was administered twice weekly, and the mean maximum weekly dose was 14.48 mg. The response was A5 (regrowth=100.0%) in 14 (48.3%) patients and A4 (regrowth of 75%~90%) in 12 (41.4%) patients. Three patients had poor response to LD-MTX treatment (A2: n=2 [6.9%], A1: n=1 [3.4%]). All three of the patients showing a poor response had disease durations exceeding 24 months. Relapse was observed in 31% of patients with more than 75% regrowth. Common side-effects were elevated liver enzyme levels and gastrointestinal discomfort. CONCLUSION:LD-MTX appears to be an effective and well-tolerated treatment for recalcitrant AA multiplex.
journal_name
Ann Dermatoljournal_title
Annals of dermatologyauthors
Lim SK,Lim CA,Kwon IS,Im M,Seo YJ,Kim CD,Lee JH,Lee Ydoi
10.5021/ad.2017.29.3.263subject
Has Abstractpub_date
2017-06-01 00:00:00pages
263-267issue
3eissn
1013-9087issn
2005-3894journal_volume
29pub_type
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