Journal Scan / Research · March 29, 2018

Methotrexate for the Treatment of Pediatric Alopecia Areata

The Journal of Dermatological Treatment

TAKE-HOME MESSAGE

A retrospective chart review was used to compile 14 cases of pediatric alopecia areata treated with methotrexate. A total of 12 patients also completed a prednisone taper either before, concurrent with, or overlapping with methotrexate administration. Overall, 1 case was lost to follow-up, and 2 participants discontinued methotrexate prematurely; 3 patients had a partial response, 8 patients had a good response, and 4 experienced complete or near complete regrowth. All but 1 of the 11 who saw a response also completed a prednisone taper.
Methotrexate with prednisone seems to be a safe and effective treatment for alopecia areata in the pediatric population.
– Anna A. Wile, MD

Abstract

Alopecia areata is a form of nonscarring hair loss that occurs in pediatric and adult patients, with presentation varying from round or ovoid patches of alopecia to alopecia totalis or universalis. While frustrating for patients, it can also be frustrating for clinicians to treat, as there is no definitive treatment. Dermatologists are very familiar with the use of methotrexate for psoriasis and other inflammatory skin diseases, and this medication is generally well tolerated in children.

MATERIALS/METHODS

This study presents a case series reviewing the efficacy of methotrexate in our pediatric patients with alopecia areata, making use of a retrospective chart review design from 2011 to 2016.

RESULTS

In this data set, 8/14 subjects (57%) experienced good regrowth with methotrexate, while 3/14 (21%) had a response that could not be assessed due to loss to follow-up or premature discontinuation of the medication. No cases discontinued the medication due to recognized methotrexate side effects.

CONCLUSIONS

This review suggests methotrexate is a generally safe and often effective medication in pediatric alopecia areata.

Dermatología en Costa Rica

Tuesday, April 03, 2018