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December 1977

Systemic Steroids for Treatment of Alopecia Areata

Author Affiliations

Antioch, Calif

Arch Dermatol. 1977;113(12):1731-1732. doi:10.1001/archderm.1977.01640120099035

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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

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