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November 4, 1974

Treatment of Alopecia Totalis

JAMA. 1974;230(5):671. doi:10.1001/jama.1974.03240050019011

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To the Editor.—  In my opinion, the dosages that Dr. Orentreich recommended for alopecia (229:204, 1974) are inadequate and would result in the unsuccessful treatment of many patients who could benefit from an increased dosage of both preparations. These patients should be treated initially with at least 30 mg of prednisone per day, tapering rapidly to 10 to 15 mg/day over a period of one month, and thereafter the dosage adjusted according to apparent need. Intralesionally administered steroids should be used so that systemic treatment can be kept to a minimum; however, the amounts I have used have been 3 ml of a 3.33-mg/ml solution of triamcinolone acetonide every two to three weeks.I reported on the successful treatment of two patients with alopecia totalis in the Canadian Medical Association Journal on Jan 20, 1973. Since that time, we have treated a total of ten patients, eight of whom have had