Background
The use of pulse dose corticosteroid therapy (PDCT) in children for treatment of alopecia areata (AA) has been reported, but dosing regimens are not well‐established. We aim to evaluate the available literature regarding the utilization and various dosing regimens of PDCT, as well as associated side effects, in the treatment of AA in children.
Methods
We performed a systematic review of studies describing the use of PDCT for the treatment of AA in children.
Results
Eight relevant studies were identified, five of which administered the treatment intravenously (IV) and three of which administered the treatment orally. Protocols with IV administration included two studies which used IV dexamethasone at 1.5 mg/kg/day for 1–3 days monthly for a maximum of 12 cycles and three studies used IV methylprednisolone 8–30 mg/kg/day for 1–3 days monthly for a maximum of 3–10 cycles. The three protocols with oral administration included variable doses of prednisolone at variable intervals and cycle lengths, betamethasone and dexamethasone at a prednisolone equivalent of 5 mg/kg, and methylprednisolone 15 mg/kg for 3 days bimonthly for 12 cycles. In these studies, PDCT was generally well‐tolerated and resulted in improvement of the AA.
Conclusion
PDCT was found to be well‐tolerated with few serious side effects reported. It appears to be beneficial early in disease course, especially for those with multifocal AA.
Bazex syndrome, also known as Acrokeratosis paraneoplastica, is a paraneoplastic disorder characterized by erythematous psoriasiform plaques involving the nose, ears, and acral sites. Although classically associated with squamous cell carcinomas of the upper aerodigestive tract, it has also been reported in association with adenocarcinoma, genitourinary tumors, multiple myeloma, and rarely, peripheral T-cell lymphoma and follicular lymphoma in-situ. Herein, we present a patient with Bazex syndrome associated with angioimmunoblastic T-cell lymphoma (AITL), a rare association not previously reported in the literature.
Vitiligo, manifested by skin hypopigmentation, is an autoimmune disorder of the skin due to the autoimmune destruction of melanocytes. Nivolumab, which is a programmed cell death–1 receptor inhibitor, is a well-known therapy for melanoma. Nivolumab-induced vitiligo has been described in literature, explained by destruction of non-cancerous melanocytes. This is considered a favorable response, due to a correlated stronger immune response against tumor cells. The average onset of the vitiligo is reported to be 5.2 months after starting the therapy, with a maximum reported onset being 9 months. We present a 52-year-old male patient whose initial vitiligo presentation occurred a year after starting the therapy and has continued for months after concluding Nivolumab therapy.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.