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Pulse dose corticosteroid therapy regimens, both in the form of oral and intravenous administration, are therapeutically beneficial and have a good safety profile in the improvement of AA in the pediatric population.

Studies report the administration of pulse dose corticosteroid therapy (PDCT) in the pediatric population for treating alopecia areata (AA); however, previous studies have not defined the dosing regimens. This systematic review aimed to include and evaluate studies involving the utilization of PDCT in the treatment of AA in the pediatric population to identify the dosing regimens, administration, and adverse effects of PDCT. This systematic review was published in Pediatric Dermatology.

The review included a total of eight studies, out of which, five involved intravenous (IV) administration of PDCT for treating AA. The remaining three studies discussed the oral administration of PDCT to the pediatric population diagnosed with AA. Among the five studies that discussed IV administration of PDCT, three protocols administered IV methylprednisolone with a dosage of 8–30 mg/kg/day for a duration of 1–3 days monthly for 3–10 cycles. The remaining two studies administered IV dexamethasone with a dosage of 1.5 mg/kg/day for a duration of 1–3 days monthly for 12 cycles. The study protocols that evaluated oral administration of PDCT comprised methylprednisolone, with a dosage of 15 mg/kg, and dexamethasone and betamethasone at a dosage equivalent to 5 mg/kg prednisolone for a duration of 3 days bimonthly for a total of 12 cycles. The systematic review reported that PDCT was well-tolerated by the study participants and mediated improvement in AA.

In summary, the administration of the PDCT regimen is well-tolerated in pediatric patients with AA, with few serious adverse effects reported for this drug regimen. PDCT has therapeutic benefits early in the course of AA, particularly in patients with multifocal lesions. 

References

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Gallaga, N. M., Carrillo, B., Good, A., Munoz-Gonzalez, A., & Ross, L. (2022). Pediatric pulse dose corticosteroid therapy dosing and administration in the treatment of alopecia areata: A review of literature. Pediatric Dermatology. https://doi.org/10.1111/pde.15209