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October 1977

Prednisone Therapy for Alopecia Areata

Arch Dermatol. 1977;113(10):1457. doi:10.1001/archderm.1977.01640100135032

To the Editor.—  Winter et al, in their article "Prednisone Therapy for Alopecia Areata"1 conclude that "long-term treatment was not accompanied by an obvious beneficial change in the natural course of alopecia areata." They also conclude that "because of the potentially serious side effects. . . . Prednisone therapy is not recommended for longterm use in alopecia areata."Because the prognosis for alopecia areata in individual cases is so variable, it is difficult to assess the effect of any therapy unless it is dramatic. Only in the case of alopecia totalis and universalis is the prognosis very clearly defined and it is therefore perhaps worthwhile to consider separately the four patients in this study who had alopecia totalis. Neither of the two conclusions just noted seem to apply to them on the basis of the evidence presented.The course of the disease in the patients with alopecia totalis was in fact far better

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