Real-World Systemic Treatment Patterns and Outcomes of Children With Severe Alopecia Areata: A French Nationwide Study (ESTAPED Cohort)

This French nationwide study examined systemic treatment patterns in 262 children with severe alopecia areata, revealing that intravenous corticosteroids were the most common first-line treatment, followed by combinations with methotrexate. The study found that psychological factors, atopic dermatitis, later onset, and female sex were linked to longer treatment durations. Treatment failure was the primary reason for discontinuation, with no serious adverse events reported. Five years post-treatment initiation, 14.5% of patients achieved remission. The study highlights the limited effectiveness of current therapies, frequent relapses, and the need for prolonged treatment, providing valuable real-world data to enhance management strategies for severe alopecia areata in children.