Alopecia Areata and Dexamethasone Mini-Pulse Therapy: A Prospective Cohort Study on Real World Evidence and Factors Related to Successful Response

The study evaluated the effectiveness and safety of dexamethasone mini-pulse therapy in 40 patients with alopecia areata (AA) who did not respond to topical treatments. Over 12 months, more than 50% of patients achieved a 50% reduction in the Severity Alopecia Tool (SALT) score at 9 months. The therapy was more effective for patients with a later onset of the disease and without hypothyroidism, while those with early onset or hypothyroidism had poorer responses. The combination with oral minoxidil did not enhance outcomes. Side effects were common, with weight gain and glycemic disorders being the most frequent, particularly at higher doses. The study concluded that mini-pulse dexamethasone is an effective treatment for AA, though not beneficial for all subgroups, and recommended further studies due to the small sample size.