Korean J Dermatol.  2020 Sep;58(8):505-511.

Therapeutic Outcomes of Long-term Low-dose Systemic Cyclosporine Treatment in Patients with Chronic Alopecia Areata

• Cho YR
• Kim KH

Abstract

Background
Alopecia areata (AA) is a T cell-mediated autoimmune disease. In patients with chronic AA, hair loss occurs because of the insidious destruction of the stem cells in the hair bulge and hair-bulb matrix along with the attack of the cytotoxic T cells and infiltration of the T-helper 17 cells. Cyclosporine (CsA) inhibits the action of calcineurin in hair stem cells and subsequently induces the inhibition of the nuclear factor of activated T cells c1 and expression of cyclin-dependent kinase 4, thereby stimulating hair regrowth.
Objective
The purpose of this study was to evaluate the long-term therapeutic outcomes of low-dose systemic CsA treatment in patients with chronic AA, relative to their initial severity of AA.
Methods
A total of 98 outpatients with chronic AA, who were treated with low-dose systemic CsA, were included in the study.
Results
Among the 98 patients, 72 (73.5%) had more than 50% hair regrowth, while 30 patients (30.6%) had more than 90% hair regrowth after 18 months of CsA treatment. Patients with a lower initial severity of alopecia tool (SALT) score demonstrated better treatment outcomes than those with a higher initial SALT score.
Conclusion
Patients with chronic AA who were treated with low-dose, systemic CsA experienced significant hair regrowth with fewer side effects. Therefore, the use of low-dose, systemic CsA is recommended in the treatment of patients with chronic AA.

Keyword

Alopecia areata; Cyclosporine