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To the Editor.—
This is a rebuttal to the rejection of corticosteroid therapy in treatment of alopecia areata by Winter et al in the November 1976 Archives (112:1549-1552).I have treated the conditions of over a dozen patients with systemic steroids, with clearing of the disease in every instance and only one instance of untoward side effect, ie, a readily controlled peptic ulcer. My protocol is to use intralesional steroids once weekly for three weeks in cases of patchy alopecia areata. If no regrowth of hair is noted, I begin treatment with combination of intralesional and intramuscular steroids—usually betamethasone valerate suspension. This last medication I frequently use on an every-other-week basis, because the duration of effect of intramuscular betamethasone is approximately one week. At times I have used intramuscular triamcinalone acetonide suspension, but this drug is less successful, perhaps because of the lower steroid blood level. Before placing the patient
Fisher DA. Systemic Steroids for Treatment of Alopecia Areata. Arch Dermatol. 1977;113(12):1731-1732. doi:10.1001/archderm.1977.01640120099035