Treatment for Alopecia Areata with Greater than 50% Involvement

Alopecia areata is a non-scarring alopecia that can present as patches of hair loss (areata, AA), complete scalp hair loss (totalis, AT) or complete scalp and body hair loss (universalis, AU). It is an autoimmune disease mediated via CD8+ T-cell activation and NKG28 signaling targeting the hair bulb. Previous reports indicate that systemic treatment with methotrexate (MTX) benefits patients with AT or AU when used alone or with systemic corticosteroid administration.

This study evaluates the utilization of MTX as a treatment modality in patients with alopecia areata who have greater than 50% hair loss. Methotrexate appears to be an effective short-term treatment option for patients with AA, including AA-ophiasis type, showing an overall 71% response rate, of which 36% of treated patients had complete re-growth. Hair regrowth occurred in 1-3 months with complete hair growth seen from…