Ann Dermatol.  2023 Jun;35(3):205-216. 10.5021/ad.22.167.

Guidelines for the Management of Patients with Alopecia Areata in Korea: Part II Systemic Treatment

Affiliations
  • 1Department of Dermatology, SMG-SNU Boramae Medical Center, Seoul, Korea
  • 2Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea
  • 3Department of Dermatology, Ajou University School of Medicine, Suwon, Korea
  • 4Department of Dermatology, Yonsei University College of Medicine, Seoul, Korea
  • 5Department of Dermatology, School of Medicine, Kyungpook National University, Daegu, Korea
  • 6Department of Dermatology, School of Medicine, Chungnam National University, Daejeon, Korea
  • 7Department of Dermatology, Guro Hospital, Korea University College of Medicine, Seoul, Korea
  • 8Department of Dermatology, Inha University School of Medicine, Incheon, Korea
  • 9Department of Dermatology, School of Medicine, Chosun University, Gwangju, Korea
  • 10Department of Dermatology, Seoul National University Bundang Hospital, Bundang, Korea
  • 11Yonsei Seran Dermatology and Laser Clinic, Seoul, Korea
  • 12Department of Dermatology, Kyung Hee University School of Medicine, Seoul, Korea

Abstract

Background
Alopecia areata (AA) is a chronic disease with an unpredictable course and can have a severe psychological impact on an individual.
Objective
To provide evidence and consensus-based statements regarding the treatment of patients with AA in Korea.
Methods
We searched for relevant studies from inception to May 2021 regarding the systemic treatment of AA. Evidence-based recommendations were also prepared. The evidence for each statement was graded and classified according to the strength of the recommendations. Hair experts from the Korean Hair Research Society (KHRS) voted on the statement, and an agreement of 75% or greater was considered as having reached consensus.
Results
Current evidence supports the efficacy of systemic corticosteroids, oral cyclosporine monotherapy or combination with systemic corticosteroids, and oral Janus kinase inhibitors in severe AA patients. Systemic steroids may be considered for pediatric patients with severe AA. A consensus was achieved in three out of nine (33.3%), and one out of three (33.3%) statements pertaining to systemic treatment in adult and pediatric AA, respectively.
Conclusion
The present study produced up-to-date, evidence-based treatment guidelines for AA associated with the consensus obtained by experts based on the Korean healthcare system.

Keyword

Alopecia areata; Guideline; Korea; Systemic; Therapeutics; Treatment
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